Tales of mental illness, ranging from the clinically depressed to the criminally insane, have always held a morbid fascination. But it is only relatively recently that sufferers have been viewed with pity and medical understanding. By the time of George III’s first bout of “madness” in 1788, treatments had progressed from the barbaric medieval practices of beating the patient and trepanning a hole in their skull. However, the “cures” remained horrific enough, as the King was about to find out.
One early preconception of the insane was that they were beasts, insensitive to temperature. This give way to the theory that chilly conditions cleared the head. In consequence, patients admitted to psychiatric hospitals such as Bedlam were hosed down with cold water and left to sleep in rooms with unglazed windows. Indeed, the air of winter was deemed so improving that the hospital didn’t bother to give patients medicine in the cold season. Fortunately for George, he was not subject to Bedlam’s keepers. However, his rooms were kept cold where possible and he was encouraged to take cool baths. When his symptoms became too extreme to conceal in December 1788, the royal family moved George from Windsor to Kew. This was mainly a bid for privacy, but there may have been another motive: Kew was a summer palace. It had no carpets or insulation for the winter months, and many courtiers testified it was like an ice house.
Once the patient was in suitably cool surroundings, doctors would try to get the madness out of them. Although they would no longer try to beat insanity out, they did their best to extract it from every orifice. George received medicines designed to cause vomiting and diarrhoea. The doctors began with rhubarb pills, moving onto musk, senna and tartar emetics. The herbs borage and hellebore were also popular “purges and vomits” of the period, believed to “purge the veins of melancholy”. I expect it only made the patient more miserable. If that was the case, physicians would move onto the blood. Leeches were applied to George’s forehead to suck out ill humours, and he was also subjected to the more traditional bleeding with a torquinet.
Another fluid thought to carry away madness was pus. In order to produce the substance, doctors needed blisters. These could be formed in several ways. Firstly, there were irritants applied directly onto the patient’s skin. George had hot vinegar rubbed on his feet and his head was shaved to receive a liberal coating of mustard powder. As for his legs, they received the treatment of “cupping”. As the name suggests, this practice used small cups, which were heated and “exhausted” of air over a lamp before application. As the air cooled, the resulting vacuum would produce blisters to be drained. Particularly harsh doctors might also cut the skin before cupping it, to draw the maximum amount of blood and pus.
Of course doctors did try to put something into patients, as well as removing substances. Quinine and opium were popular choices, although the later would have added to the sufferer’s confusion. The Architect of the new Bedlam hospital, Hooke, thought Indian Hemp (marijuana) would be beneficial to inmates, “This powder being chewed and swallowed…doth, in a short time, quite take away the memory and understanding…When he awakes he finds himself mightily refreshed.” Since the records of Bedlam show patients were also continually supplied with beer, it’s just as well Hooke’s idea never came to fruition. Diet itself was given some consideration, especially in less serious “nervous” disorders. William Buchan advised that, “Fat meats, and heavy sauces, are hurtful…All weak and warm liquors are hurtful, as tea, coffee, punch…” But the doctors could not blame diet in the case of King George; he was famously abstentious, living on plain food and barley-water.
If all else failed, the patient would be controlled by fear. Dr Willis, who came from his Lincolnshire asylum to attend George, believed this was instrumental to recovery. He first had the King separated from his family and all looking glasses removed. The keepers were instructed to return George’s blows and abuses, like for like. Willis then became a kind of harsh schoolmaster, punishing George if he refused to eat or became unmanageable. The greatest punishment, it seemed, was confinement. They started off by “sheeting” George; swaddling him tightly like an infant of the period to prevent movement. When it became clear mere linen would not do the trick, they progressed to a “strait waistcoat” made of a resilient striped material called “tick”, which was tied up with tapes much in the manner of a modern straightjacket. Clearly, George remained unruly, for Willis introduced a bulky chair with restraints on the arms and legs. Too heavy to be thrown down, the chair would hold George captive for hours. He resentfully called it his “Coronation Chair”.
Having listed all these terrifying treatments, it’s important to remember that the eighteenth century approach to madness could also be quite progressive. In the late 1600s, Bedlam hospital was rebuilt at Moorfield in a new model; one with light rooms, fresh air and exercise yards. Willis himself encouraged outdoor work and exercise at his hospital, giving the patients farms to tend. There were experiments in music therapy, and when George was good he was allowed to sing, read and play cards – all considered wholesome activities in moderation. He was allowed to see his spaniel Flora – perhaps an early form of pet therapy! – and although separation from the family was encouraged, Willis did try to grant George some access by having his younger daughters held up to the window (a singularly frightening experience for the young princesses!).
When George started to convalesce, he was prescribed rejuvenating activities such as sea bathing and mineral water. This must have been a huge relief, after all he had suffered. George doubtless went through a terrible ordeal, but one consolation was that his illness brought the plight of the “mad” into public consciousness. Greater tolerance and sympathy began to emerge, although it would be many years before the mentally ill were treated with what we would consider fitting respect.
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