Category: Caregiving

A Peculiar Postscript

Eighteenth-century letters generally contain an excess of politeness, even when one correspondent rebuked another. But every now and then, letter recipients must have been left scratching their heads—and not because of head lice…

In 1732, the Dowager Countess of Ferrers wrote to Mrs Hinde, asking her to take the letter along with payment to Sir Hans Sloane for advice on an eye problem. The letter begins with an apology for not writing to Mr Hinde. This the Countess blamed on her eye trouble, which “render’d it [writing] so uneasy to me that I now never attempt it but when forced by Business of necessity”. The Countess then found the energy to write a lengthy letter (about 1200 words) on her eye problem. Well then, that put the Hindes in their place: she was only writing because she wanted something.

Of course, there was an obvious status difference between writer and recipient here. The rules for polite behaviour that were so integral to the Republic of Letters (or when a lower-ranking person wrote to a higher-ranking recipient) did not apply when the letter writer was the social superior. The Hindes probably thought nothing of this particular comment.

But still, the real charm clincher comes in the postscript.

I am glad yr young baby and misses have so much Health & strength & gives so much entertainment to ye whole Family, I cannot say that I ever could give into ye amusement of being able to divert my self with little Children but I have often envy’d those that found pleasure in them & therefore give Mrs Hinde Joy upon that occasion.

Two mothers with crying babies and one in a walking frame; comparing the human infant's helplessness with the self-sufficiency of newborn animals. Engraving by P. Galle, c. 1563. Credit: Wellcome Library, London.

Two mothers with crying babies and one in a walking frame; comparing the human infant’s helplessness with the self-sufficiency of newborn animals. Engraving by P. Galle, c. 1563. Credit: Wellcome Library, London.

Righto. And this is what I hear it as:

Congratulations on the birth of your baby, if that’s what makes you happy. I hate small kids. And I’m sorry not sorry that I never liked them.

Anyway, social status notwithstanding, the Countess’ somewhat peculiar (if unintentionally hilarious) postscript surely must have left the Hindes wondering how long they could reasonably wait before passing on the letter to Sloane. And given that the Countess had sent the letter from France, there could have been any number of possible reasons for a delay.

Bethlem Bed Shortages in the Eighteenth Century

I just read an excellent post by Jennifer Evans (@historianjen) over at earlymodernmedicine on a sad case of madness from Hans Sloane’s correspondence. Go read the post in full, but to sum it up: over several months in 1714, the Earl of Derby was attempting to care for John Getting, who was in clearly declining mental health. The Earl wondered about the possibility of committing Getting to Bethlem, as the case had become too difficult to manage. Although the outcome can’t be traced, Evans wonders if Getting was admitted to Bethlem Hospital (also known as Bethlehem or Bedlam).

Maybe. Getting doesn’t appear in the letters again–but being admitted to Bethlem was not easy, nor did it provide long-term care.

We regularly complain about hospital bed shortages, but the situation was even more complicated in the eighteenth century! Mental health care primarily occurred in the home, although Bethlem Hospital and private care were an option for more difficult cases. There were few charitable hospitals overall and a chronic shortage of space. The early eighteenth-century Bethlem, for example, had only just over 100 places.[1] (The population of London in 1715 was around 630,000, but to make matters more complicated, Bethlem patients like Getting might come from outside of London.)

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

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

Bethlem was able to remain a charitable hospital largely through its fundraising: it doubled as a tourist attraction for rich and poor alike, with visitors expected to leave donations. Frenchman Cesar de Saussure, for example, described his tour of Bethlem. On the first floor, visitors could look in the little windows of cells at “these poor creatures” or, in the big gallery, pass by the “many inoffensive madmen” allowed to walk around. Cells on the second floor held “dangerous maniacs, most of them being chained and terrible to behold”. The building may have been grand, but it was a “melancholy abode”.

Patients being assessed could stay at Bethlem, but that did not always result in admission, as this fascinating case from Bethlem Blog suggests. Admission into most early eighteenth-century English hospitals was granted through patronage or—in the case of the Foundling Hospital (founded 1741)—by lottery. As a physician for Christ’s Hospital (1694-1730) and on the Board of Governors for St. Bartholomew’s, Sloane was frequently asked for assistance in obtaining admission for patients. But as the post on Getting reveals, admission to Bethlem could be helped by a charitable donation—and, perhaps, the assistance of important patrons like Sloane and Derby.

Another case from the Sloane correspondence, however, suggests the difficulty of finding long-term care for those in dire need. Ambrose Godfrey, a chemist well-known to Sloane for his analysis of the properties of stones and waters, wrote a distressed letter to Sloane in July 1724 on behalf of Mr. Steiger (an engraver).

Godfrey had known Mrs. Steiger and her brother well for nearly forty years, but the brother “had lost his understanding” and the family hoped to have him admitted to Bethlem. The Bethlem physician, however, “refuses it, alledging that there is no roome”. Godfrey hoped that a letter from Sloane might help. The situation was, indeed, dire.

He has been already been ones before in Bedlem & was sent out as cured. But being now as bad as ever & Threatning to stab them, haveing done already very dangerous things, it would be great charity good S’r if you could be instrumentall to get him in again, the dangerous prancks he has played will else be the ruin of my friend who has already the Burthen & care of 3 of this mad mans children upon his back.

It’s clear that in helping the Steiger family, Godfrey was asking Sloane for a very personal favour: “I am deeply concerned for them”, he wrote, and “it would be as much satisfaction to me see their request fulefilled, as if they ware relations of my own”. In the event that personal recommendation was insufficient, Godfrey also pointed out the brother’s good reputation. He had “ben a man of much credit & served all the offices in ye parish of Gracion’s street”.

Statues of "raving" and "melancholy" madness, each reclining on one half of a broken segmental pediment, formerly crowning the gates at Bethlem [Bedlam] Hospital. Engraving by C. Warren, 1808, after C. Cibber, 1680. Image Credit: Wellcome Library, London.

Statues of “raving” and “melancholy” madness, each reclining on one half of a broken segmental pediment, formerly crowning the gates at Bethlem [Bedlam] Hospital. Engraving by C. Warren, 1808, after C. Cibber, 1680. Image Credit: Wellcome Library, London.

So why the stickiness over admissions and the insistence in discharging an obviously ill patient? A charitable hospital like Bethlem needed to show that it was successful in curing people in order to attract patronage. To that end, according to Bethlem Blog, those patients accepted into Bethlem were most likely to be easily treatable within a year or two. It was not until the late 1720s that Bethlem opened an “incurable” ward—and that was only available to patients already in the hospital. After a year of treatment and assessment, severely ill patients might be transferred to the ward.

Might. The waiting list to enter the ward was long.

It’s hard to say what happened to either Getting or Mrs. Steiger’s brother, but their sad cases predated the incurable ward. At best, if the men were admitted to Bethlem, the Steiger family and Earl of Derby might have had a couple years respite; in the brother’s case, this might even have coincided with the opening of the new ward. At worst? Well, the Earl had the inclination, money and assistance to continue helping Getting. As for the Steiger family, however, I dread to think. Mrs Steiger’s brother was a danger to the family: the costs of caregiving for a family could be high, indeed.

[1] Christine Stevenson, “Robert Hooke’s Bethlem”, Journal of the Society of Architectural Historians 55, 3 (1996): 254–275.