The history of Psychiatry
Mad-Doctors & Mad-House Keepers of the 1750's

"I think it is a very hard case for a man to be locked up in an asylum and kept there; you may call it anything you like, but it is a prison." (Sir James Coxe, testimony before the House of Commons Select Committee on the Operations of the Lunacy Laws, 1877)


Also known as "alienists", Mad Doctors were the forerunners of psychiatrists.

They were quacks in the 18th century and they are still quacks today!

Click to ViewSee also: History of Psychiatry homepage

Click to View


Click to View

"The keepers at Bedlam are idle, skulking, pilfering scoundrels, eccentric, murders, have something peculiar about them, strange in appearance, bribery is common to all, cruelty is common to all, villainy is common to all, in short every thing is common but virtue." (Urbane Metcalf 1818, John Conolly 1859)



 Click to ViewSee also: History of Psychiatry homepage

  1. "Mad doctors" also known as "alienists", Doctors were the forerunners of psychiatrists.
  2. "Alienists" was a title they derived from standing up and testifying in open court about a persons mental health.
  3. The "keepers" of the Mad houses, known today as psychiatric nurses!
  4. The "keeper managers" are known today as psychiatric nurse managers of a ward.
  5. "Many of the asylum doctors were no more than medically qualified gaolers [jailers], whose only attempts at "care" were the tactics of restraint and punishment so angrily summarised by Swift a century earlier.  "Though 'tis hopeless to reclaim them, scorpion rods perhaps may tame them" [Jonathan Swift.]" (British Psychiatry at 150, J. Birley, Lancet, 1991 AD)
  6. "T. Bakewell (1815) had stated that, at some madhouses, the pecuniary interest of the proprietor and the secret wishes of the lunatics' relatives, led not only to the neglect of all means of cure, but also to the deliberate prevention and delay of recovery, conduct which he considered a crime that may be perpetrated with perfect impunity as to human laws'. This statement is in keeping with what Mitford (1825 ?) claimed to be the rule at Warburton's house, namely: 'If a man comes in here mad, we'll keep him so; if he is in his senses, we'll soon drive him out of them." Similarly, 100 years previously, Defoe had stated that if persons were not mad on entering a madhouse, they were soon made so by the barbarous usage they there suffer . . . Is it not enough to make one mad to be suddenly clap'd up, stripp'd, whipp'd, ill fed, and worse us'd ? C. Crowther (1838) observed that in private-madhouses the rich did not recover in the same proportion as the poor"." (The Trade in Lunacy, William Ll. Parry-Jones, 1972 AD, p 241)

 Click to ViewFull discussion and analysis of William Battie's
"A Treatise on Madness"

Click to View
William Battie

A. The Mad doctors power thirst" Banish the preachers!

  1. Psychiatry has a long history of being hostile to Christianity! This is where it all began. The mess we currently find ourselves in 2010 AD, started in the 1700's with the creation and centralization of mad houses.
  2. They were viewed as quacks by almost everyone and quacks they were, but worked hard at gaining respect with an increasingly well organized campaign.
  3. In the 1800's mad doctors succeeded in gained trust with elected officials, the courts and the general public who blindly viewed them as "experts".
  4. In the 1600's it is clear that preachers of churches (clergyman) played a central role in treating and helping the mentally ill. This new breed of generally atheistic mad doctors needed to replace the traditional and God given role of preachers with themselves!
  5. In order to carve out their own territory, one of the first things they did was keep preachers of local churches out of every aspect of the mentally ill and mad houses. Indeed, they made the outrageous claim that preachers and Christians actually caused people to be mentally ill. In fact they openly stated that anyone claiming to have divine guidance were automatically mentally ill.
  6. By the end of the 1700's preachers were formally barred from not only having input in determining if a person is insane, they were actually banned from even entering the mental hospitals!
  7. This process continues today where insurance companies and lawyers actually advise local churches and preachers NOT to even counsel anyone, even if they are sane! This represents a complete take over of a territory once owned by preachers and churches! It is driven by power, money and atheism! Welcome to the world of modern psychiatry!
  8. "The rise of psychiatry as an organized profession, with which we shall be concerned in the following chapters, is thus but a particular instance of a much broader phenomenon, what Harold Perkin has termed "the rise of professional society." During the nineteenth century, knowledge-particularly but not exclusively scientific knowledge-increasingly became a resource from which a variety of newly consolidating and self-conscious groups sought to extract a living. Mad-doctors, or as they increasingly preferred to call themselves, alienists or medical psychologists, were merely one of a whole array of groups seeking recognition and social status on this basis. Unlike their entrepreneurial counterparts in the manufacturing sector, the new professionals were in the business of selling something intangible: skill and expertise rather than material goods." (The Transformation Of The Mad-Doctoring Trade, Andrew Scull, 1994 AD, p 5)
  9. "Like others engaged in this project of collective social mobility, mad-doctors had to seek public approval and trust, and as they struggled to establish control over a particular territory and to define and protect the boundaries of their jurisdiction, they necessarily found themselves engaged in a never-ending campaign of persuasion and propaganda. Trust is vital to the professional because he or she needs to secure assent to claims to possess, not just skills and knowledge that the laity lacks, but skills and knowledge the professional argues the public is not even in a position to assess with any degree of precision. Likewise, the laity must come to trust that members of the profession will exercise their skills in a disinterested fashion and in large degree must be persuaded to rely upon the professionals' own valuation of their knowledge. Yet trust was a particularly difficult commodity for mad-doctors to acquire, not least because their involvement in the trade in lunacy prompted endemic suspicion about their motives, and because their claims to possess expertise in the identification and treatment of madness provoked persistent scepticism even among those laymen most heavily involved in the campaign for lunacy reform. The prominent role played by medical men in the whole series of scandals about treatment in asylums and madhouses that erupted in the first half of the nineteenth century only intensified the difficulty of the task they confronted. Yet, in the face of these and other obstacles, a recognized specialism did emerge over the course of the nineteenth century and secured some signifificant respect. The mad-doctors known to the authorities grew from two or three thousand in 1800 to almost one hundred thousand [100,000] a century later, their guardians successfully constituted themselves as the public arbiters of mental disorder, the experts in its diagnosis and disposal. They created a professional organization to defend and advance their interests and edited journals and wrote monographs to provide a forum for transmitting (and giving visible evidence of) the body of expert knowledge to which they laid claim. During Victoria's long reign, they increasingly dominated public discourse about insanity, and in the process, they elaborated and refined a set of career structures and opportunities for themselves. Fragile as their public standing might be, marginal and somewhat embarrassing as their medical brethren might find them, psychiatrists nonetheless had secured some accoutrements of professional status, if only as the custodians of a chronically incapacitated and generally economically deprived clientele and as advisers on mental hygiene to a broader population concerned to avoid such a dismal destiny." (The Transformation Of The Mad-Doctoring Trade, Andrew Scull, 1994 AD, p 6)

B. The Mad doctors "causes" (etiology) of mental illness:

  1. As we trace the opinions of mad doctors as to the etiology of insanity, we see a common theme: a combination of bad living + bad bodies (bad blood, bad brain matter, bad nerve fibers)
  2. In John Monro openly stated that no one would ever discover the cause of mental illness that he certainly had no idea. However, he prescribed all the standard humoral treatments of bloodletting and vomits. It appears Monro was more concerned with controlling the mentally ill by chains and jail cells, than research into the causes and treatments of madness.
  3. "John Monro was without question one of the most famous mad-doctors of his generation. Besides his position at Bethlem Hospital, he was also a major figure in the emerging private "trade in lunacy" that was so notable a feature of eighteenth-century England's burgeoning consumer society. Monro attended Bethlem at a time when the hospital's custom of exposing the insane to the eyes of sightseers reached its apogee. In the last years of his tenure as its physician, the practice was radically curtailed—though not at his initiative—after a wave of public, literary, and media protest. Recognized by contemporaries as a leading authority on insanity, Monro's close social connections with members of the aristocracy and gentry, as well as with medical professionals, politicians, and divines, ensured for him a significant place in the social, political, cultural, and intellectual world of his time." (Undertaker of the mind: John Monro, Jonathan Andrews, Andrew Scull, 2001 AD, p xiv)
  4. Whereas John Monro allowed the public to enter the asylums to mock, ridicule and torment the insane, Battie rejected all this and made the asylum a quiet place of peace. But there were other asylums that were already doing this like Dr. Fox's mad house near Bristol, so Battie was merely copying them. "The patient was to be removed entirely from the context wherein he or she had become mad, including family, friends and external pressures. Only in such a state of asylum could treatment have a chance of success. Moreover, Battie dismissed a wide range of conventional treatments, ... asserting that management, by which he meant a temperate and ordered mode of living within the regimen of the asylum, would do more than medicine, and that any application of medicine should be judged according to the needs and constitution of the patient." (Patterns of Madness in the Eighteenth Century, A Reader, Allan Ingram, 1998 AD, p112)
  5. William Battie was in important historical figure because he wrote a complete book on defining, diagnosing and treating madness, including the causes of madness. He was a quack, but there are valuable lessons to be learned because in many ways, modern psychiatry has made almost no progress from William Battie in 1750 AD.

C. Mad house Keepers: Overview

Click to View

  1. The keepers at Bedlam are idle, skulking, pilfering scoundrels, eccentric, murders, have something peculiar about them, strange in appearance, bribery is common to all, cruelty is common to all, villainy is common to all, in short every thing is common but virtue.
  2. "this I will say of [keeper] Rodbird, that he is an idle, skulking, pilfering scoundrel, and during the time I am speaking of, he was not upon an average, in his gallery three hours in the day and this could not be without the stewards knowledge and connivance." (The Interior Of Bethlem Hospital, Urbane Metcalf, 1818 AD)
  3. "It would extend far beyond the limits of this little work to portray the villainies practised by the Jacks in office, bribery is common to them all; cruelty is common to them all; villainy is common to them all; in short every thing is common but virtue, which is so uncommon they take care to lock it up as a rarity. Like other establishments this appears to be erected too much for the purpose of making lucrative places; the apartments appropriated to the use of the officers are elegant in the extreme, every thing which luxury can covet is at their command; they eat, they fatten, while the poor creatures under their charge are left to all the miseries which confinement and privation can inflict; good God; in England, in this country, so famed for its munificence, surely the miseries of the wretched inmates of this humane institution are totally unknown to the exalted characters who support it, they should not sleep till the abuses are altogether removed; their supiness is the villain's security, their activity alone can prevent the new establishment falling a prey to the miseries and cruelties which disgraced Old Bethlehem." (The Interior Of Bethlem Hospital, Urbane Metcalf, 1818 AD)
  4. "The class of people taking care of lunatics [keepers] has, within my own experience, very much improved, I remember when almost every man who kept [i.e. hospital nurses] an asylum was an eccentric, or had something peculiar about him, or strange in his appearance, and was more calculated to knock a patient down than to cure him; that was the general character of them." (John Conolly, testimony before the House of Commons Select Committee on the Care and Treatment of Lunatics, 1859)
  5. "I was under a keeper of the name of Davies; far be it from me unnecessarily to rake up the ashes of the dead, but this I must say, he was a cruel, unjust and drunken man, and for many years as keeper secretly practised the greatest cruelties to those under his care; he was some time previous to his death, porter, and when he died the committee had the goodness, thinking he had been a good servant, to give a handsome sum towards the expences of his funeral, but they were greatly deceived." (The Interior Of Bethlem Hospital, Urbane Metcalf, 1818 AD)

Mad house Keepers: Murderers

  1. Murders: "This man [Blackburn] possesses an improper control over the officers, and no doubt stands high in the estimation of some governors, I will endeavour to unmask him. In the Old House there was a patient of the name of Fowler, who one morning was put in the bath by Blackburn, who ordered a patient then bathing, to hold him down, he did so, and the consequence was the death of Fowler, and though this was known to the then officers it was hushed up; shameful!" (The Interior Of Bethlem Hospital, Urbane Metcalf, 1818 AD)
  2. Chained to death by Gangrene: "Likewise a patient named Popplestone, I believe he came from Cornwall, during a severe winter was so long chained in his room that the iron round his leg literally eat into his flesh, in this dreadful state he lay unattended, until Blackburn [keeper manager] became accidentally acquainted with his situation, the lock was clogged with dirt so that he Blackburn, was obliged to borrow an awl of Truelock to clear it; a short time afterwards Popplestone's leg rotted off and he died in the house, this should have been sufficient to provoke an investigation, but it was hushed up; shameful neglect!" (The Interior Of Bethlem Hospital, Urbane Metcalf, 1818 AD)

Mad house Keepers: Sexual assaulting women

  1. Sexual assault by the male "Keepers": "Do you remember a keeper of the name of King, at Bethlem, who is now at Liverpool? Perfectly. Was not he employed as keeper of the female patients at Bethlem? He was occasionally. Was not King, when keeper of the female patients, charged by Mr. Till, the manager of the London waterworks, with being too familiar with a female patient of great beauty, such female having been a servant of Mr. Till? I do not know that he was charged by Mr. Till with too great familiarity, but the patient herself did charge him with that. He being the keeper of the female patients at that time? Yes; she complained to me of it. What was the result of that investigation? There was great asseveration on one side, and denial of it on the other; I do not know whether we got at the truth. Was not the regulation immediately made by the governors, for not again employing men as keepers of women? They had endeavoured to do that long before, upon another business. Did not the governors, from learning that fact, direct that no man should again be put as keeper of the women? I do not recollect that they came to any resolution upon that case; it was about three years ago." (Report From The Committee On Madhouses In England, 1815 AD, Testimony of John Haslam)
  2. Sexual assault by the male "Keepers": "Some years ago, a female patient had been impregnated twice, during the time she was in the Hospital; at one time she miscarried; and the person who was proved to have had connexion with her, being a keeper, was accordingly discharged." (Report From The Committee On Madhouses In England, 1815 AD, Testimony of John Haslam)

Mad house Keepers: Neglect of human needs

  1. neglectful with bad food: "Mr. Humby the steward, in my humble opinion acts with great injustice, he admits provisions of the worst quality; the beer during the twelve months that I speak of was exceedingly bad, not fit in general, for any person to drink, the cheese was very bad; the butter was very often bad; the meat in general very bad; the potatoes very bad; none of the provisions fair upon an average but the bread, and I have understood that is not under his management." (The Interior Of Bethlem Hospital, Urbane Metcalf, 1818 AD)
  2. Neglectful of basic human needs: "There is a patient of the name of William Stockley, who is a poor confused creature, he is a strong young man, but he is entirely made a slave of by the keeper and by any other patient that pleases in the gallery, and not only so, but he is sent a great deal of his time down into the laundry to be made a drudge of there, and this with Mr. H. the steward's knowledge and leave; and very often is sent to bed without his supper through Mr. Rodbird's kindness, and I know that he has not a clean pair of stockings more than once in three months, though his friends and the governors no doubt, think he is made comfortable." (The Interior Of Bethlem Hospital, Urbane Metcalf, 1818 AD)

Mad house Keepers: Thieves and pilferers

  1. Pilfers: "Charles Saunders, had in the old house, though as inoffensive as a child, had been kept chained for years, that the keeper might have his clothes to sell." (The Interior Of Bethlem Hospital, Urbane Metcalf, 1818 AD)
  2. Thieves and pilferers: "Mr. Vickery the cutter [butcher], has it in his power to defraud the patients in many instances, and he never suffers an opportunity to pass without gratifying his disposition to pilfering, this cutter cuts down the allowances to some purpose, for instance, there are two hundred patients in the house, and supposing he restrains his theft to one ounce per head, in the meat he takes 36 lb. per week as his own perquisites, bread in proportion; these perquisites he sells and manages to live comfortably by depriving the patients of part of the food intended for their sustenance." (The Interior Of Bethlem Hospital, Urbane Metcalf, 1818 AD)

Mad house Keepers: Abusive, brutal, beatings

  1. Abusive: "Another patient of the name of Leonard, is in general a very quiet man, I have known Rodbird the keeper, abuse him repeatedly and set the other patients on to do it." (The Interior Of Bethlem Hospital, Urbane Metcalf, 1818 AD)
  2. Brutal: "Whilst looking at some of the bed-lying patients [at Bedlam], a man arose naked from his bed, and had deliberately and quietly walked a few paces from his cell door along the gallery; he was instantly seized by the keepers, thrown into his bed, and leg-locked, without enquiry or observation: chains are universally substituted for the strait-waistcoat. In the men's wing were about 75 or 76 patients, with two keepers and an assistant, and about the same number of patients on the women's side; the patients were in no way distinguished from each other as to disease, than as those who are not walking about or chained in the side rooms, were lying stark naked upon straw on their bedsteads, each in a separate cell, with a single blanket or rug, in which the patient usually lay huddled up, as if impatient of cold, and generally chained to the bed-place in the shape of a trough; about one-fifth were in this state, or chained in the side rooms." (Report From The Committee On Madhouses In England, 1815 AD, Testimony of A. Mr. E. Wakefield)
  3. Brutal: "The Interior Of Bethlem Hospital, which he published immediately after his release, is thus not only a unique insight into the new regime after only two years, it also affords Metcalf the opportunity to make comparisons with the old Moorfields Bethlem. While the new, according to Metcalf is infinitely preferable, his pamphlet is nevertheless a protest over conditions, in the line of Bruckshaw and Belcher, which are intolerable, he asserts, because of the corruption and brutality of the keepers. ... Metcalf has had first-hand experience, but as an observer, not as a participant." (Patterns of Madness in the Eighteenth Century, A Reader, Allan Ingram, 1998 AD, p 256)
  4. Beatings for no reason: "Another patient named Harris, for the trifling offence of wanting to remain in his room a little longer one morning than usual, was dragged by Blackburn [keeper manager], assisted by Allen, the basement keeper, from No. 18, to Blackburn's room, and there beaten by them unmercifully; when he came out his head was streaming with blood, and Allen in his civil way wished him good morning." (The Interior Of Bethlem Hospital, Urbane Metcalf, 1818 AD)
  5. Beatings for no reason: "The case of Morris; this man had some pills to take, which he contrived to secrete in his waistcoat pocket, this Blackburn [keeper manager] discovered, and by the assistance of Allen, they got him to his room and there beat him so dreadfully for ten minutes as to leave him totally incapable of moving for some time, Rodbird was looking out to give them notice of the approach of any of the officers; they are three villians." (The Interior Of Bethlem Hospital, Urbane Metcalf, 1818 AD)
  6. Brutal beatings for no reason: "Coles, a patient of Blackburn's [keeper manager], one day, for refusing to take his physic [medicine to induce vomits], was by Blackburn and Rodbird beat and dashed violently against the wall several times, in the presence of the steward, though from the general tenor of this man's conduct it is probable a little persuasion would have been sufficient to induce him to take the medicine quietly, Coles is since put upon the long list, [The 'long list' would be those patients regarded as incurable.] and is now in the upper gallery." (The Interior Of Bethlem Hospital, Urbane Metcalf, 1818 AD)


  1. Although William Battie was a quack, many of his treatments resemble modern psychiatry.
  2. Regarding the torture of the insane, all we can say is to quote Urbane Metcalf: "Good God; in England, in this country?"
  3. Mad houses and their keepers, were truly a very black mark against humanity.
  4. If this is what the mental hospitals were like, what were the jails like?



By Steve Rudd: Contact the author for comments, input or corrections.

Send us your story about your experience with modern Psychiatry


Click to View