# Early Insane Asylums Were a Living Nightmare

An episode of [Human History ASMR](https://invisiblenetwork.ai/podcast/6793196842), 8 Oct 2026, 57 min.

Audio: https://dts.podtrac.com/redirect.mp3/api.spreaker.com/download/episode/75560598/early_insane_asylums_were_a_living_nightmare_human_voiced_no_ads.mp3

Early Insane Asylums Were a Living NightmareJourney into the disturbing history of the earliest mental asylums and discover what life was really like for people confined within institutions designed to treat mental illness. From overcrowded wards and harsh restraints to experimental treatments and desperate attempts at reform, this episode explores the realities behind some of the darkest chapters in the history of psychiatric care.Travel back to the eighteenth and nineteenth centuries, when ideas about mental illness were changing but medical knowledge remained limited. Discover why institutions were established, who was sent into them, and how people experiencing mental distress could find themselves confined alongside individuals with epilepsy, intellectual disabilities, dementia, or conditions that society simply did not understand.Explore the daily realities of asylum life. Examine the crowded dormitories, inadequate sanitation, poor nutrition, rigid routines, isolation, and limited privacy that affected many patients. Discover how shortages of staff, insufficient funding, and rapidly growing populations sometimes transformed institutions intended for treatment into places of neglect and suffering.The episode also examines the treatments used during this period. Learn about mechanical restraints, isolation, cold-water treatments, purging, and other historical practices, while exploring the medical theories that supported them. Discover the gradual emergence of more humane approaches, including moral treatment, and why reform efforts often struggled against overcrowding, institutional bureaucracy, and limited resources.Behind the walls were human lives and individual stories. Explore the experiences of patients, families, physicians, nurses, attendants, and reformers who shaped the development of psychiatric institutions. Examine how poverty, social prejudice, family circumstances, and restrictive laws could influence who was admitted, how long they remained, and whether they ever returned home.Go beyond sensational stories and popular myths to investigate what historical records actually reveal. Patient casebooks, admission registers, medical reports, photographs, institutional correspondence, and firsthand accounts help reconstruct asylum life, although experiences differed significantly between institutions and historical periods.Drawing on historical documents, medical records, patient testimonies, and modern scholarship, this episode separates documented abuses from exaggerated legends and explores how early asylums influenced the development of modern mental healthcare.Narrated with a calm, human voice, this immersive historical journey is perfect for history enthusiasts, medical history lovers, psychology audiences, documentary listeners, relaxation, or listening before sleep. Step behind the locked doors of the early asylum and discover the people, practices, failures, and reform movements that changed the history of psychiatric care.

## Transcript

[0:01] Speaker 1: I want you to imagine walking through a dim, foul-smelling corridor,
[0:08] Speaker 1: where chains clank with every shuffling step. From behind iron-barred
[0:13] Speaker 1: doors come unnatural screams and sobbing pleas. The air is
[0:19] Speaker 1: thick with stench of unwashed bodies. In one cell, a
[0:24] Speaker 1: man lies shackled to the wall, half-naked and malnourished, muttering incoherently.
[0:31] Speaker 1: Down the hall, a woman in a soiled, dirty gown,
[0:35] Speaker 1: rocks on the floor, her ankle chained to the bed,
[0:40] Speaker 1: while a pair of well-dressed onlookers peer in through a
[0:43] Speaker 1: small window, leering, observing the lunatics on display. This is
[0:52] Speaker 1: not a scene from a horror film. It's just the
[0:55] Speaker 1: reality of the world's first mental asylums. Hospitals meant to
[1:02] Speaker 1: cure and treat the troubled, but instead became houses of torment,
[1:08] Speaker 1: where cruelty was routine and suffering was the norm. From
[1:14] Speaker 1: the early days of England's notorious Bethlehem Asylum, mental institutions
[1:20] Speaker 1: earned a deservedly nightmarish reputation that spanned centuries and continents.
[1:26] Speaker 1: The historian Roy Porter aptly called London's Bethlehem Hospital a
[1:32] Speaker 1: symbol for man's inhumanity to man, for callousness and cruelty.
[1:39] Speaker 1: It was in these halls beatings, starvation, and bizarre treatments
[1:45] Speaker 1: were inflicted on the helpless in the name of care.
[1:50] Speaker 1: As the asylum system spread to America in the 19th century,
[1:54] Speaker 1: the same patterns often followed. Grand buildings, overcrowded, filled with
[2:01] Speaker 1: abuse and outdated remedies that seemed more like methods of torture.
[2:09] Speaker 1: So today we're going to explore the dark chapters of
[2:12] Speaker 1: early insane asylums in the UK and the USA. We'll
[2:17] Speaker 1: visit the most infamous institutions, from Bevelem in London to
[2:22] Speaker 1: the sprawling Victorian hospitals in America. and shine a light
[2:27] Speaker 1: on the cruel treatments that their inmates had endured. And
[2:32] Speaker 1: along the way you're going to hear some real historical anecdotes,
[2:36] Speaker 1: the true story behind Bedlam's legends, a Quaker woman's mysterious
[2:41] Speaker 1: death sparking outrage in York, a reporter's daring exposé of
[2:46] Speaker 1: abuse in New York, and doctors who pulled patients' teeth,
[2:52] Speaker 1: or even cut into their brains in misguided attempts to
[2:56] Speaker 1: cure their madness. So prepare to be shocked, perhaps dismayed,
[3:03] Speaker 1: by these authentic historical accounts. I think by the end
[3:07] Speaker 1: we'll have walked the wards of history's most nightmarish asylums,
[3:11] Speaker 1: and learned the forgotten truths of how the generations before
[3:15] Speaker 1: us treated those who they deemed insane. The journey begins
[3:21] Speaker 1: in London, where for centuries One name was synonymous with
[3:26] Speaker 1: the horrors of these institutions, and that name was Bethlehem.
[3:36] Speaker 1: But where are my manners? I'll first welcome you to
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[4:03] Speaker 1: So now let's begin. The story of institutionalized cruelty begins
[4:09] Speaker 1: with Bethlehem Royal Hospital in London, better known by its nickname, Bedlam.
[4:18] Speaker 1: Founded in the 13th century as a religious hospice, By
[4:22] Speaker 1: the 1400s it had become England's first asylum for the insane.
[4:27] Speaker 1: For the desperate poor, deemed mad, Bedlam was often the
[4:32] Speaker 1: end of the line. Here, under the guise of care,
[4:38] Speaker 1: inmates lived in squalor and brutality. Conditions behind Bedlam's walls
[4:44] Speaker 1: were medieval at best. Patients, often called prisoners by staff,
[4:50] Speaker 1: and I'm not joking— were kept in tiny cells, often
[4:54] Speaker 1: with no furnishings but a straw pallet. Chains, manacles, locks
[5:02] Speaker 1: and stocks filled the inventories of the asylum. It was
[5:08] Speaker 1: believed that madness could be shocked or beaten out of
[5:12] Speaker 1: a person quite literally. Staff whipped and flogged inmates as
[5:17] Speaker 1: a supposed treatment, thinking pain might jolt the mind back
[5:21] Speaker 1: to sanity. kind of like hitting the top of your
[5:24] Speaker 1: television when it refuses to work. I assume that's the logic.
[5:29] Speaker 1: One can imagine the screams echoing throughout the stone halls
[5:33] Speaker 1: as another, quote, patient is struck for relapsing into delirium. Now,
[5:39] Speaker 1: if they were not being beaten, many were simply left
[5:42] Speaker 1: shackled to the walls in their own filth, nonetheless. In 1598...
[5:49] Speaker 1: Bedlam's governors noted that loathsomely filthy state of the cells
[5:55] Speaker 1: and that inmates lacked even basic clothing or eating utensils.
[6:01] Speaker 1: Cleanliness and comfort were afterthoughts. Restraint and control, they were
[6:08] Speaker 1: the priorities. And so, by the 1700s, Bedlam had become
[6:15] Speaker 1: a public spectacle. The asylum infamously opened its doors to
[6:19] Speaker 1: paying visitors, turning misery into a tourist attraction. Curious Londoners,
[6:26] Speaker 1: from ladies and gentlemen to rowdy holiday crowds, wandered the wards,
[6:31] Speaker 1: gawking at the lunatics on display. On peak days, hundreds
[6:37] Speaker 1: of visitors streamed through the galleries. They would laugh at
[6:40] Speaker 1: patients babbling nonsense, or cowered at the sight of the
[6:45] Speaker 1: truly disturbed One Swiss traveller, César de Saussure, described in
[6:51] Speaker 1: 1775 how on holidays, I quote, numerous persons amused themselves
[6:57] Speaker 1: watching these unfortunate wretches, who often gave them cause for laughter.
[7:03] Speaker 1: He excited that melancholy abode. The bedlam porter expected a tip,
[7:11] Speaker 1: and if given a silver coin, he pocketed it all.
[7:15] Speaker 1: Bedlam's human zoo was lucrative. Donations from visitors bought in
[7:20] Speaker 1: around 300 pounds per year in the mid-1700s, and that
[7:24] Speaker 1: was a huge sum back then. The hospital eagerly welcomed
[7:28] Speaker 1: the public to parade through. Of course, it was the
[7:32] Speaker 1: patients who paid the real price. They were tormented, poked
[7:38] Speaker 1: with sticks, and harassed by the thrill-seekers. Some applied with alcohol,
[7:46] Speaker 1: to make them act out. This grotesque voyeurism was condoned
[7:50] Speaker 1: because it raised funds, even as it degraded and tormented
[7:55] Speaker 1: the very people needing care. Inside Bedlam, outright abuse was frequent.
[8:02] Speaker 1: In the late 1700s, the Monroe family of doctors presided
[8:06] Speaker 1: over the hospital and kept to a regimen of cruelty. Dr.
[8:10] Speaker 1: John Monroe and his son Thomas rejected this new moral treatment.
[8:16] Speaker 1: which emphasized kindness and calm, and instead insisted on violent
[8:22] Speaker 1: physical remedy. They used spinning chairs to whirl patients at
[8:27] Speaker 1: high speed, applied leeches to bleed them, and routinely resorted
[8:33] Speaker 1: to starving and beating patients into submission. These practices were
[8:38] Speaker 1: widely considered torturous, even in their own time. under the
[8:42] Speaker 1: Monroes Bedlam also continued to host throngs of sightseers. The
[8:48] Speaker 1: doctors even allowed visitors at night, for an extra fee,
[8:51] Speaker 1: to poke fun at inmates chained in their rooms, prodding
[8:55] Speaker 1: them with sticks to provoke reactions. Meanwhile, attendants sometimes embezzled
[9:02] Speaker 1: food donations, selling off provisions meant for patients, and left
[9:08] Speaker 1: the mentally ill, malnourished and starving, Bedlam was also used
[9:14] Speaker 1: as a convenient dumping ground for the right price for
[9:20] Speaker 1: unwanted relatives or troublesome spouses. They could be committed there
[9:24] Speaker 1: on dubious grounds, effectively disappearing into the world of nightmare.
[9:30] Speaker 1: One infamous case forced the outside world to actually confront
[9:34] Speaker 1: Bedlam's horrors. In 1814, a Quaker philanthropist named Edward Wakefield
[9:40] Speaker 1: managed to slip into the asylum and and discovered a
[9:43] Speaker 1: patient named James Norris in an appalling state. Norris was
[9:49] Speaker 1: actually an American member of the Navy, who had been
[9:53] Speaker 1: locked up at Bedlam for over a decade. Wakefield found
[9:57] Speaker 1: him chained upright to a metal bar, a stout iron
[10:01] Speaker 1: ring clamped round his neck, and attached to a vertical
[10:05] Speaker 1: iron rod set in the wall. Iron hoops also encircled
[10:10] Speaker 1: Norris's chest and arms, fitting his arms to his sides.
[10:14] Speaker 1: He had been kept in this iron harness continuously for
[10:18] Speaker 1: about twelve years. Wakefield learned that attendants would sometimes yank
[10:24] Speaker 1: Norris's chains and slam him against the wall for their
[10:27] Speaker 1: own amusement. For Norris, every day was an unending torment.
[10:34] Speaker 1: He could not lie down to sleep. He could barely
[10:37] Speaker 1: feed himself. Reportedly his beard grew long, and his clothes
[10:42] Speaker 1: rotted away from his body. He spent day and night
[10:47] Speaker 1: fixed in one spot. The man treated worse than a
[10:53] Speaker 1: caged animal. When Parliament learned of his plight, it became
[10:58] Speaker 1: a scandal, symbolizing everything that was wrong with Bedlam. By 1815,
[11:06] Speaker 1: the public outrage over such abuse could no longer be ignored.
[11:09] Speaker 1: Investigations into Bedlam and other madhouses uncovered naked, mistreated patients,
[11:15] Speaker 1: and systematic brutality. One witness described inmates chained to the walls,
[11:21] Speaker 1: unwashed and unclosed, treated like wild beasts by thuggish keepers.
[11:28] Speaker 1: Bedlam's chief physician, Thomas Munro, was forced to resign in
[11:33] Speaker 1: 1816 for wanting inhumanity towards patients. Reforms slowly followed. Chains
[11:41] Speaker 1: were gradually removed. and scandalized officials pushed for more oversight
[11:47] Speaker 1: of asylums. But Bedlam's centuries-long reign of cruelty was not
[11:53] Speaker 1: so easily forgotten. The name Bedlam entered the English language
[11:59] Speaker 1: as a synonym for chaos and madness, forever linked to
[12:04] Speaker 1: the atrocious conditions once inside its walls. But, One good
[12:14] Speaker 1: thing did come out of it. Bedlam's abuses did spur change.
[12:19] Speaker 1: After the 1815 parliamentary inquiry, the British public became more
[12:24] Speaker 1: aware of the madhouse atrocities. Other scandals emerged, notably the
[12:31] Speaker 1: York Lunatic Asylum. That supposedly respectable York Asylum had been
[12:37] Speaker 1: founded in 1777. But by the 1810s, there were rumours
[12:39] Speaker 1: that swirling of horrific neglect within its walls. In one
[12:48] Speaker 1: notorious case, a Quaker woman named Hannah Mills was admitted
[12:53] Speaker 1: in 1794, melancholy. When fellow Quakers tried to visit her,
[12:58] Speaker 1: the asylum refused them entry. It was only weeks later
[13:04] Speaker 1: that Hannah was dead. Whispers hinted that she had been
[13:09] Speaker 1: abused and left to die. The charge at the asylum,
[13:13] Speaker 1: of course, denied completely. But before a full investigation could occur,
[13:19] Speaker 1: a mysterious fire broke out in 1814, conveniently destroying the
[13:26] Speaker 1: asylum's records and killing four patients along the way. Many
[13:31] Speaker 1: suspected the blaze was deliberately set to hide the evidence
[13:34] Speaker 1: of abuse. A local magistrate, Godfrey Higgins, relentlessly pushed for
[13:39] Speaker 1: an inquiry, despite the lost records. and it came to
[13:45] Speaker 1: light that York Asylum had not allowed independent inspections for years.
[13:52] Speaker 1: Witnesses later testified to beatings, S.A., and filthy conditions. The
[13:59] Speaker 1: scandal led to an influential Quaker, William Duke, to pledge
[14:04] Speaker 1: to create a benevolent institution for Quakers with mental illness,
[14:09] Speaker 1: and thus the York Retreat was established. Notably, in 1793
[14:13] Speaker 1: in Paris, Philippe Pinel had dramatically removed the chains from
[14:19] Speaker 1: the mad at Bicet Hospital, symbolizing a new humane era.
[14:25] Speaker 1: But in far too many places, literal or metaphorical chains
[14:28] Speaker 1: stayed on for decades to come. These revelations in York
[14:33] Speaker 1: and London helped fuel the drive for reform. In 1828,
[14:37] Speaker 1: Britain passed a law to license and inspect private asylums
[14:43] Speaker 1: attempting to curb the worst abuses. A new generation of
[14:48] Speaker 1: superintendents emerged, with genuinely humanitarian ideas. At Lincoln and Hanwell
[14:56] Speaker 1: asylums in the 1830s, leaders experimented with abolishing mechanical restraints entirely. Dr.
[15:04] Speaker 1: John Connolly of Hanwell, the large Middlesex County Asylum, famously
[15:10] Speaker 1: instituted a strict non-restraint policy in 1839. No more chains,
[15:17] Speaker 1: no straight jackets, no manacles. Patients were to be managed
[15:22] Speaker 1: with gentleness and supervision alone. Remarkably, Connolly succeeded, through improved
[15:30] Speaker 1: staffing and careful oversight. Hanwell's hundreds of patients were calmed
[15:36] Speaker 1: without the whip or the fetter. This was revolutionary proof
[15:42] Speaker 1: that the, quote, mad did not have to be treated
[15:45] Speaker 1: like convicts, like they'd done something wrong. And quite soon after,
[15:52] Speaker 1: non-restraints became accepted practice throughout England, at least in the
[15:58] Speaker 1: well-run public asylums. Visitors to progressive asylums in Victorian times,
[16:04] Speaker 1: like writer Harriet Martineau's tour of Hanwell in 1834, noted
[16:09] Speaker 1: a few improvements. Patients engaged in work and recreation. They
[16:15] Speaker 1: had decent food, too. And that old tradition of brutality
[16:20] Speaker 1: was pretty much gone. But the reform was uneven. While
[16:30] Speaker 1: some asylums became more humane, others, especially overcrowded, out-of-sight institutions,
[16:37] Speaker 1: Quietly continued the old practices behind closed doors. The new
[16:42] Speaker 1: laws could be skirted, or poorly enforced. An 1850s investigator
[16:47] Speaker 1: still found padded cells reeking of excrement, and attendants using
[16:52] Speaker 1: leather straps to tie patients to bedsteads in certain country asylums.
[16:58] Speaker 1: Change came slowly, often only after publicized tragedies. Indeed, The
[17:06] Speaker 1: 19th century saw an explosion in asylum population. In 1800,
[17:12] Speaker 1: only a few hundred lunatics were confined in all of England.
[17:18] Speaker 1: By 1900, 100,000 plus people were living in British asylums,
[17:26] Speaker 1: a scale unimaginable in earlier times. That exponential growth often
[17:32] Speaker 1: outpaced humane oversight, of course. By the late 19th century,
[17:37] Speaker 1: most British asylums had officially banned chaining and whipping. But
[17:43] Speaker 1: neglect and overuse of isolation remained problems. So in short,
[17:51] Speaker 1: Britain made halting progress. Outrage sparked inquiries. The inquiries led
[17:58] Speaker 1: to laws. And more enlightened doctors demonstrated a new and
[18:04] Speaker 1: better way but the dark roots of the system were
[18:09] Speaker 1: not so easily dug out. The British experience, a blend
[18:15] Speaker 1: of scandal, reform and relapse, set the stage. Across the ocean,
[18:21] Speaker 1: the Americans were watching and determined to build a more
[18:25] Speaker 1: enlightened asylum system. But they would soon learn, however, how
[18:30] Speaker 1: easily the same horrors of mismanagement and mistreatment could take
[18:35] Speaker 1: hold on their own soil In the early United States,
[18:43] Speaker 1: the plight of the mentally ill was, if anything, even
[18:47] Speaker 1: more desperate. Before dedicated asylums existed, those who were deemed
[18:52] Speaker 1: insane were often locked up like common criminals, or locked
[18:57] Speaker 1: up in the attic like Disney protagonists. In 1843, social
[19:03] Speaker 1: reformer Dorothea Dix reported finding mentally ill people confined in cages, closets, Sellers, stalls, pens, chained, naked,
[19:14] Speaker 1: beaten with rods and lashed into obedience. Her memorial to
[19:19] Speaker 1: the Massachusetts legislature painted a horrifying picture. Vulnerable men and
[19:24] Speaker 1: women shivering half-naked in the cold, filthy cells, sometimes lashed
[19:30] Speaker 1: to posts or kept in pens like animals. Doesn't sound
[19:34] Speaker 1: very good, doesn't it? Many at the time mistakenly believed
[19:38] Speaker 1: that the insane... were not sensible to external circumstance. The
[19:44] Speaker 1: dungeon's chains, cold and nakedness, were acceptable to them as
[19:48] Speaker 1: comfort and care. Dix forcibly dispelled this myth, insisting that
[19:56] Speaker 1: those with mental illness suffered keenly from such mistreatment and
[20:02] Speaker 1: deserved proper shelter and compassion. Dix's crusade galvanized Americans to
[20:09] Speaker 1: act They resolved to build institutions that they believed would
[20:14] Speaker 1: be a lot more humane, true refuges for healing, rather
[20:19] Speaker 1: than those of neglect. And thus began the rapid growth
[20:23] Speaker 1: of the American insane asylum in the 19th century. Early
[20:28] Speaker 1: efforts were pretty hopeful. In 1773, Colonial Virginia had opened
[20:35] Speaker 1: its first public system in Williamsburg. and by the 1820s
[20:39] Speaker 1: and 1830s, other states followed. Even in America's colonial era,
[20:45] Speaker 1: the same voyeurism occurred. The Pennsylvania Hospital in Philadelphia. Lunatics
[20:51] Speaker 1: were kept in a basement, and the public could pay
[20:54] Speaker 1: a small fee to gawk at them on certain days.
[20:58] Speaker 1: Reformers embraced the moral treatment principle from Europe, a regimen
[21:03] Speaker 1: of kindness, routine, and productive activity. So they designed asylums
[21:11] Speaker 1: to be peaceful havens where disturbed minds could rest and recover. Dr.
[21:17] Speaker 1: Thomas Kirkbride of Pennsylvania pioneered a standard asylum template, a
[21:22] Speaker 1: grand building in a serene rural setting, with airy wards
[21:27] Speaker 1: and sunlit parlors. You know the ones. You've seen them
[21:32] Speaker 1: in the movies. Kirkbride's influential design featured a long bat wing,
[21:40] Speaker 1: sort of set up and towering central spires, making many
[21:44] Speaker 1: asylums look like castles or even palaces. By the mid-1800s,
[21:52] Speaker 1: dozens of these elaborate hospitals arose across the US landscape.
[21:57] Speaker 1: On paper, they were idealistic places offering rest, work and
[22:01] Speaker 1: gentle discipline. In practice, however, Many American asylums quickly slid
[22:07] Speaker 1: into the same nightmare conditions seen in Bedlam. Patient populations swelled,
[22:13] Speaker 1: far beyond what anyone had anticipated. For example, the imposing
[22:18] Speaker 1: Danvers State Hospital in Massachusetts opened 1878, was built to
[22:23] Speaker 1: house 500 patients amid bucolic hills. But within 20 years,
[22:30] Speaker 1: it held over a thousand of them. crammed into every
[22:34] Speaker 1: available space. This overcrowding led to a collapse of humane care.
[22:41] Speaker 1: The nationwide trend was similar. In 1850, only a few
[22:45] Speaker 1: thousand mentally ill people were in asylums across America. But
[22:49] Speaker 1: by 1904, there were 150,000. This ballooning continued into the
[22:56] Speaker 1: 20th century, reaching over 500,000 patients in state hospitals by 1950.
[23:03] Speaker 1: Such staggering overcrowding virtually guaranteed that many institutions would descend
[23:09] Speaker 1: into mere human warehouses rather than curative havens. It was
[23:15] Speaker 1: only a matter of time until things fell apart. Like
[23:20] Speaker 1: their British counterparts, American doctors often resorted to brutal methods
[23:25] Speaker 1: to control patients. Mechanical restraints were ubiquitous, restraining chairs. handcuffs, chains,
[23:33] Speaker 1: and the infamous Utica Crib. What is an Utica Crib?
[23:39] Speaker 1: It's kind of like a coffin-like wooden box with a
[23:43] Speaker 1: slatted lid, barely three feet wide and six feet long.
[23:49] Speaker 1: First introduced in the 1840s at the New York State
[23:52] Speaker 1: Lunatic Asylum in Utica, it was meant to safely confine
[23:56] Speaker 1: violent patients. but in reality it became a tool of
[24:00] Speaker 1: convenience and punishment. Unruly patients would be shut for hours,
[24:05] Speaker 1: even overnight, in these cage beds, unable to sit or stand.
[24:11] Speaker 1: Some liken the experience to being buried alive. The cribs
[24:15] Speaker 1: were widely adopted by asylums in the US and Canada,
[24:19] Speaker 1: despite public criticism. Only in 1887 did Utica's superintendent finally
[24:26] Speaker 1: order every crib removed from the wards My then countless
[24:30] Speaker 1: patients had already known the terror of that boxed imprisonment. Horrible.
[24:36] Speaker 1: Absolutely horrible. But even seemingly progressive asylum doctors often inflicted pain.
[24:45] Speaker 1: Bloodletting and purging, standard 19th century medical practices, were liberally
[24:51] Speaker 1: applied to the mentally ill. In the early 1800s, Dr.
[24:54] Speaker 1: Benjamin Rush... revered as the father of American psychiatry, insisted
[25:01] Speaker 1: that insanity was caused by congestion of blood vessels in
[25:05] Speaker 1: the brain. His remedies included bleeding patients routinely and dosing
[25:12] Speaker 1: them with mercury-laced purgatives until they were violently ill. Rush
[25:18] Speaker 1: also invented a contraption called the tranquilizing chair, which sounds
[25:23] Speaker 1: about as fun as it is. This device, essentially a
[25:26] Speaker 1: heavy wooden chair with straps to immobilize the patient's arms,
[25:30] Speaker 1: legs and head, was used to bind agitated patients for
[25:34] Speaker 1: hours at a time. It was supposed to physically force
[25:38] Speaker 1: calm by slowing the circulation. But in truth, it was
[25:43] Speaker 1: just another form of sensory deprivation and punishment. A similar gadget,
[25:48] Speaker 1: the gyrator, spun patients on a horizontal wheel to induce
[25:54] Speaker 1: dizzying shock. Such methods were used well into the mid-19th
[25:58] Speaker 1: century under the guise of curing the illness. But as
[26:03] Speaker 1: the decades passed, the optimistic vision of cure gave way
[26:08] Speaker 1: to a more harsh reality. Many asylums just became holding pens,
[26:15] Speaker 1: more about containment than treatment, keeping the undesirables off the streets.
[26:21] Speaker 1: State legislatures chronically underfunded these institutions. leading to sparse staffing
[26:27] Speaker 1: and meagre supplies. Neglect invited disaster. Patients slept on straw
[26:33] Speaker 1: mats in dirty, drafty wards. Disease was rampant. Death rates
[26:39] Speaker 1: were high. An inspector in 1880 found the asylum in Milleville, Georgia,
[26:46] Speaker 1: had fifty patients packed into a single room, many lying
[26:50] Speaker 1: in their own filth. At Blackwell's Island in New York,
[26:55] Speaker 1: the city's public insane asylum. Conditions were exposed by undercover
[26:59] Speaker 1: reporter Nellie Bly as nothing short of hellish. Bly feigned
[27:05] Speaker 1: insanity in 1887 to get committed to Blackwell's. How brave
[27:10] Speaker 1: is that? And then her published account, Ten Days in
[27:15] Speaker 1: a Madhouse, shocked the entire nation. She found rotting food,
[27:21] Speaker 1: ice-cold baths and casual violence on the women's ward, Patients
[27:26] Speaker 1: were forced to endure freezing baths, and then put to
[27:30] Speaker 1: bed soaking wet, shivering until they almost froze. Many women
[27:36] Speaker 1: at Blackwell's were not actually insane at all, merely poor
[27:40] Speaker 1: or just foreign-born, yet they were treated with cruelty. Blyde
[27:45] Speaker 1: described nurses choking or beating patients for minor infractions. One
[27:50] Speaker 1: delusional woman who begged, For God's sake, ladies, don't let
[27:55] Speaker 1: them beat me, was grabbed by her hair by a nurse,
[27:59] Speaker 1: dragged shrieking from the room, later found tied up in
[28:03] Speaker 1: a straight jacket. Inmates who dared complain about the freezing
[28:08] Speaker 1: temperatures or abusive attendance were threatened or struck. Bly wrote,
[28:15] Speaker 1: I have seen patients dashed headlong onto the floor, and
[28:19] Speaker 1: others given black eyes, that the nurses blithely explained away.
[28:26] Speaker 1: Food consisted of spoiled meat, gristly soup, and bread that
[28:31] Speaker 1: was little more than dried dough, so vile that many
[28:35] Speaker 1: just went hungry. Bly's courageous expose revealed that the American
[28:40] Speaker 1: asylum system could be just as abusive as the old bedlam,
[28:45] Speaker 1: despite all the rhetoric of reform. It was all a lie.
[28:51] Speaker 1: Her articles prompted a grand jury investigation and some immediate changes.
[28:55] Speaker 1: More funding. A couple people got fired, sure. But the
[29:00] Speaker 1: deeper problems of a rotten system were harder to remove. Now,
[29:08] Speaker 1: if you'll permit me to step back for a moment,
[29:11] Speaker 1: I'm going to go into storyteller mode. Describing the day
[29:16] Speaker 1: in a lunatic ward around 1880. A little bit of
[29:19] Speaker 1: a departure. from the history, but it's a good way
[29:22] Speaker 1: to introduce this section. As Hell Door creaks open at dawn,
[29:29] Speaker 1: the attendant clangs a metal cup against the bars to
[29:32] Speaker 1: rouse you and dozens of other patients on the ward.
[29:36] Speaker 1: You sleep on a straw-filled mattress on the floor. with
[29:40] Speaker 1: only a threadbare blanket. The air is frigid. There's no
[29:45] Speaker 1: heating for the insane. Shivering, you line up with the
[29:49] Speaker 1: others for breakfast in the dining hall. Balls of thin
[29:53] Speaker 1: oatmeal await. It's burnt. No flavour. The bread's black and hard.
[30:00] Speaker 1: But if you don't eat it quickly, the nurse might
[30:02] Speaker 1: yell or shove you. One woman refuses her food. She's
[30:08] Speaker 1: wrestled to the ground, force-fed through a tube. After this
[30:13] Speaker 1: meagre meal, there's not much to do. You spend the
[30:17] Speaker 1: morning sitting on a hard bench in a barren day-room.
[30:21] Speaker 1: Some patients mumble to themselves or pace back and forth endlessly.
[30:25] Speaker 1: A man from across you screams periodically. An aide tries
[30:31] Speaker 1: to put him into a restraining chair until he quiets.
[30:36] Speaker 1: Another patient won't stop sobbing. Two attendants drag her down
[30:40] Speaker 1: the hall for an icy shower treatment. A pleas echo
[30:45] Speaker 1: as she's doused with the freezing water. By the afternoon,
[30:50] Speaker 1: the ward reeks of the unwashed. There are no activities
[30:55] Speaker 1: or therapy. Only endless hours of dull confinement. An older
[31:00] Speaker 1: patient approaches an attendant to ask for a clean shirt.
[31:04] Speaker 1: He's told to shut up and shoved away. Any small
[31:09] Speaker 1: misbehaviour might earn a slap or a day in the
[31:13] Speaker 1: mania room, solitary confinement. Nights are the worst of all, though.
[31:20] Speaker 1: In the darkness, the ward fills with cries of distress.
[31:24] Speaker 1: Some patients rattle their chains or bang on their doors.
[31:29] Speaker 1: You curl up on your straw pallet, still damp from
[31:31] Speaker 1: the earlier bath, try to block out the sounds. Sleep comes, fitfully,
[31:39] Speaker 1: if it comes at all. In a few hours, the
[31:43] Speaker 1: cycle of misery will begin again. Good night. Sleep tight.
[31:50] Speaker 1: So by the dawn of the early 20th century, massive
[31:54] Speaker 1: asylum complexes dominated the approach to mental illness in the U.S.,
[31:58] Speaker 1: Nearly every state had one or more large hospitals for
[32:02] Speaker 1: the insane, often overcrowded and isolated. Behind their high walls,
[32:08] Speaker 1: outdated and dangerous treatments continued to proliferate. Doctors kept experimenting
[32:14] Speaker 1: with new cures that now sound utterly ghastly. In the 1910s, Dr.
[32:21] Speaker 1: Henry Cotton at Trenton State Hospital believed mental illness was
[32:26] Speaker 1: caused by hidden infections in the body. Well, what was
[32:31] Speaker 1: his solution? Surgically remove the body parts. Over several years,
[32:39] Speaker 1: Cotton and his staff extracted thousands of teeth from patients,
[32:44] Speaker 1: often every single tooth in their mouth, convinced that infected
[32:48] Speaker 1: teeth caused madness. When that failed to cure them, they
[32:53] Speaker 1: moved on to tonsils. Colons, gallbladders, ovaries, any organ they
[33:00] Speaker 1: suspected of harboring infection. Patients already mentally fragile were subjected
[33:06] Speaker 1: to grotesque internal surgeries and involuntary mutilation. Not surprisingly, many
[33:14] Speaker 1: died from these procedures, and most of the rest never improved.
[33:20] Speaker 1: For a time, Cotton claimed high cure rates and was
[33:23] Speaker 1: hailed to some as a pioneer. even as his hospital
[33:27] Speaker 1: wards turned into operating theaters of horror. Likewise, American asylums
[33:34] Speaker 1: were early adopters of shock therapies. By the early 1930s,
[33:40] Speaker 1: desperate to manage unruly patients in cramped wards, psychiatrists tried
[33:45] Speaker 1: inducing seizures or comas as treatment. They injected insulin to
[33:51] Speaker 1: cause daily coma seizures. or metrazole, to trigger violent convulsions,
[33:58] Speaker 1: treatments that often led patients with broken bones and terrified
[34:02] Speaker 1: of the next session. Soon after came the ultimate brutality
[34:07] Speaker 1: of the cure, the lobotomy. First performed in the US
[34:12] Speaker 1: in 1936, lobotomy involved cutting or destroying parts of the
[34:17] Speaker 1: frontal lobes of the brain. Dr. Walter Freeman's infamous transorbital
[34:22] Speaker 1: lobotomy hammering an ice pick through the eye socket into
[34:26] Speaker 1: the brain, was fast. It could be done on a
[34:29] Speaker 1: ward with a few resources. He travelled to asylums, performing
[34:34] Speaker 1: dozens in a day. By the late 1940s, tens of
[34:39] Speaker 1: thousands of asylum patients had been lobotomised. Some did become docile,
[34:46] Speaker 1: but only because they were left with the intellect and
[34:50] Speaker 1: personality of an infant. Others suffered seizures, paralysis or death.
[34:58] Speaker 1: Lobotomy is now regarded as one of psychiatry's most barbaric mistakes.
[35:04] Speaker 1: Even after the Second World War, appalling conditions persisted in
[35:08] Speaker 1: some asylums. In 1942, for instance, two attendants at a
[35:13] Speaker 1: New York State hospital were arrested for beating and abusing patients.
[35:19] Speaker 1: One of the first Times employees faced criminal punishment. Yet
[35:24] Speaker 1: such accountability was the exception, not the rule. In 1946,
[35:32] Speaker 1: Life magazine ran a searing exposé titled Bedlam 1946, revealing
[35:39] Speaker 1: abuses at two large state hospitals, Pennsylvania's Bibury Asylum and
[35:45] Speaker 1: Ohio Cleveland's State Hospital. Photos show naked, emaciated men huddled
[35:51] Speaker 1: in filthy wards, scenes indistinguishable from cattle pens. Patients lie
[35:57] Speaker 1: on bare floors, in their own waste, while overwhelmed staff
[36:01] Speaker 1: looked on indifferently. These images horrified the American public, and
[36:08] Speaker 1: showed that little had changed in the worst institutions, despite
[36:12] Speaker 1: a century of what people thought was progress. It was
[36:16] Speaker 1: a final straw. Public pressure was and a new psychiatric
[36:21] Speaker 1: drug program in the 1950s, would soon lead to the
[36:25] Speaker 1: emptying out of these, as they were called, snake bits.
[36:30] Speaker 1: The fact that a place like Bibury, with 5,000 patients
[36:33] Speaker 1: crammed into conditions as bad as any in Bedlam's history,
[36:37] Speaker 1: could exist in 1946, was a sobering testament to how
[36:41] Speaker 1: deeply entrenched the problems really were. The voices of the
[36:48] Speaker 1: patients themselves began emerging in the early 20th century, confirming
[36:52] Speaker 1: the abusers from an insider perspective. One notable witness was
[36:57] Speaker 1: Clifford Whittingham Beers, a Yale-educated man who was institutionalized in
[37:02] Speaker 1: several hospitals after a mental breakdown in 1900. Beers endured
[37:09] Speaker 1: and observed cruelty firsthand, and later recounted it in his
[37:13] Speaker 1: 1908 autobiography, a mind that found itself. In one private sanatorium,
[37:21] Speaker 1: when he became wanting to take his own life, the
[37:24] Speaker 1: staff's solution was not compassionate care, but brutal restraint. He
[37:30] Speaker 1: describes how at night his attendants would lock his hands
[37:34] Speaker 1: into a muff, a restraining device that imprisoned both hands
[37:38] Speaker 1: in a rigid leather pouch, and tie it to the
[37:42] Speaker 1: bed to prevent self-harm. To him this was a detestable
[37:46] Speaker 1: form of restraint which amounted to torture. By day, if
[37:51] Speaker 1: he did not obey orders, he was roughly overpowered by
[37:54] Speaker 1: two attendants who would pin his arms and forcibly compel
[37:59] Speaker 1: him to comply. There was also witness fellow patients being mistreated.
[38:06] Speaker 1: In one instance he saw an elderly, confused man kicked
[38:09] Speaker 1: and slapped by an attendant for failing to move quickly enough.
[38:13] Speaker 1: Such incidences were common. And Beers feared that if he
[38:19] Speaker 1: didn't speak up, that the abuse of helpless thousands would continue.
[38:25] Speaker 1: He noted that many attendants were ill-qualified and hot-tempered, enforcing
[38:30] Speaker 1: strict obedience with violence, because they simply did not understand
[38:34] Speaker 1: mental illness. Some attendants were simply indifferent, or just obeying orders.
[38:41] Speaker 1: but there were others who seemed to relish the power
[38:43] Speaker 1: they had. Bears eventually recovered and left the asylum, and
[38:48] Speaker 1: his book became a rallying cry for mental health reform.
[38:53] Speaker 1: It was shocking for the public to hear a sane,
[38:55] Speaker 1: articulate man described being trapped like an animal in these
[38:59] Speaker 1: institutions that were supposed to help him. Bears' account added
[39:03] Speaker 1: powerful confirmation that patients lived in constant fear of those
[39:07] Speaker 1: charged with their care. His work helped spur the creation
[39:12] Speaker 1: of the National Committee for Mental Hygiene and further reforms
[39:15] Speaker 1: in the 1910s. By hearing the testimony of survivors like Beers,
[39:22] Speaker 1: society could no longer dismiss all the asylum inmates as
[39:26] Speaker 1: unreliable narrators of their own experiences. Their stories matched the
[39:30] Speaker 1: awful findings of investigators and journalists. Whether it was the
[39:35] Speaker 1: manacled prisoner of Bedlam in 1815, the chained woman of
[39:39] Speaker 1: Blackwell's Island in 1887, or the traumatized college graduate like
[39:45] Speaker 1: Beers in 1902, the theme was disturbingly consistent. Insane asylums
[39:52] Speaker 1: were often terrifying places, and they were far from therapeutic sanctuaries. Okay,
[40:01] Speaker 1: so before we go, we're going to have a look
[40:03] Speaker 1: at more of these outdated treatments and conditions inflicted upon
[40:06] Speaker 1: the patients. Of course, the first, just in everything, exists
[40:13] Speaker 1: in that environment of neglect and filth. Basic care was
[40:19] Speaker 1: often lacking, Patients might go weeks without bathing or a
[40:23] Speaker 1: change of clothes. Insect and rodent infestations were rife. One
[40:29] Speaker 1: investigation found vermin crawling on patients' beds even. Overwhelmed staff
[40:34] Speaker 1: sometimes left incontinent or sick patients lying in soiled bedding
[40:38] Speaker 1: for days. And such neglect wasn't just unpleasant. It caused
[40:44] Speaker 1: epidemics of typhus, tuberculosis, and all manner of disease that
[40:49] Speaker 1: killed many patients prematurely. Bloodletting and purging. Based on humoral medicine,
[40:59] Speaker 1: patients were deliberately bled, sometimes to the point of fainting,
[41:04] Speaker 1: or given powerful laxatives to balance the body. Dr. Benjamin
[41:09] Speaker 1: Rush was a famous proponent of bleeding the insane, but
[41:12] Speaker 1: in reality it just weakened and traumatized them. They were
[41:16] Speaker 1: already in poor enough health as it is, And by
[41:20] Speaker 1: and in the early 19th century we have rotational therapy.
[41:24] Speaker 1: It involves strapping patients to a chair or hanging bed
[41:30] Speaker 1: and spinning them at high speed. Doctors hoped that the
[41:34] Speaker 1: resulting vertigo would shock the mind back to sanity. More
[41:39] Speaker 1: often it just induced vomiting, unconsciousness and terror. Now a device,
[41:46] Speaker 1: kind of like the one invented by Rush, was the
[41:49] Speaker 1: tranquilizing chair. Essentially a big, heavy wooden chair with straps
[41:54] Speaker 1: to immobilise the patient's limbs and head, with a box
[41:58] Speaker 1: to confine the head. Patients could be left for hours,
[42:05] Speaker 1: even fed and made to relieve themselves in the chair too.
[42:09] Speaker 1: It was believed to physically force calmness, but of course
[42:13] Speaker 1: it just gave them enormous distress and often injury. And
[42:18] Speaker 1: then there was a form of hydrotherapy, Cold water baths
[42:22] Speaker 1: and showers used well into the twentieth century. Agitated patients
[42:27] Speaker 1: might be suddenly plunged into an icy tub, or doused
[42:31] Speaker 1: in cold shower water as a shock to the system.
[42:35] Speaker 1: Others were kept in lukewarm, continuous baths for hours, or
[42:41] Speaker 1: wrapped tightly in cold, wet sheets that would dry and constrict,
[42:46] Speaker 1: effectively swaddling them. Nellie Bly's expose described women forced into
[42:52] Speaker 1: freezing baths and put into bed as soaking wet as punishment.
[42:58] Speaker 1: Of course, the use of straight jackets is one of
[43:01] Speaker 1: those images that we have conjured up. The use of
[43:04] Speaker 1: canvas jackets with long sleeves tied behind the back became
[43:08] Speaker 1: common in the 1800s as a way to subdue violent patients.
[43:13] Speaker 1: Some live nearly permanently in these restraints. Other inventions like
[43:18] Speaker 1: the Utica crib that we talked about similarly kept patients
[43:22] Speaker 1: physically incapacitated for long periods. These devices often cause muscle atrophy,
[43:28] Speaker 1: joint pain, and, of course, profound despair. As an alternative
[43:34] Speaker 1: to the mechanical strains, many asylums simply used prolonged solitary confinement.
[43:41] Speaker 1: Patients might be locked in a small padded cell for days,
[43:44] Speaker 1: Weeks or even months with minimal human contact. It's enough
[43:48] Speaker 1: to make you go crazy. Doctors thought that the quiet
[43:52] Speaker 1: and lack of stimulus might settle disturbed minds, but of course,
[43:57] Speaker 1: we know that wasn't going to work. In reality, the
[44:00] Speaker 1: loneliness often magnified the patient's anguish and drove them to
[44:05] Speaker 1: a deeper insanity. And if they weren't insane before they
[44:09] Speaker 1: went in, they probably would be when they came out.
[44:13] Speaker 1: Of course, before modern anti-psychotics, asylum doctors relied heavily on sedatives,
[44:19] Speaker 1: that being opium, chloral hydrate, bromides and later barbiturates, to
[44:26] Speaker 1: knock patients into submission. Doses were crude and often excessive,
[44:31] Speaker 1: leaving patients in a stupor or with addictions. Over-medication was
[44:35] Speaker 1: an easy substitute for humane care. But starting in the 1930s,
[44:41] Speaker 1: Methods like insulin coma therapy, that is, injecting insulin to
[44:46] Speaker 1: induce daily comas, and metrazole convulsive therapy triggering violent seizures
[44:51] Speaker 1: were introduced. While a few patients showed improvement, many others
[44:56] Speaker 1: suffered broken bones and brain damage. The treatments provoked terror.
[45:01] Speaker 1: Patients often begged to skip the next session. But the crescendo,
[45:08] Speaker 1: of course, was lobotomy. Introduced in 1935, the surgical destruction
[45:15] Speaker 1: of brain tissue to dull emotions. Doctors would literally cut
[45:20] Speaker 1: the neural connections of the frontal lobes. In the 1940s,
[45:25] Speaker 1: tens of thousands of asylum patients worldwide were lobotomized. Some
[45:29] Speaker 1: became docile, but at the cost of personality and intellect,
[45:34] Speaker 1: they were empty shells. Many others were left blunted, disabled
[45:39] Speaker 1: for life. Lobotomy has since been condemned as one of
[45:43] Speaker 1: the worst medical mistakes in history. So really, to sum
[45:49] Speaker 1: up today, I suppose the tale of the early insane
[45:52] Speaker 1: asylums is grim and ironic. Institutions meant to heal, instead
[45:59] Speaker 1: often harmed. But it is one that we have to
[46:02] Speaker 1: confront to understand the progress of psychiatry and, in general,
[46:07] Speaker 1: human rights. In the span of two centuries, Society went
[46:11] Speaker 1: from chaining mentally ill individuals in dungeons to seeking more compassionate,
[46:17] Speaker 1: scientific treatments, however imperfect they may be. The patients suffering
[46:23] Speaker 1: in Bedlam's fetters and Blackwell's locked wards, it wasn't all
[46:28] Speaker 1: in vain. Their plight eventually stirred conscience and reform. Dorothy
[46:35] Speaker 1: Dix's Crusades, Nellie Bly's Revelations, and the courage of whistleblowers
[46:40] Speaker 1: like Wakefield and Beers, helped turn the tide by forcing
[46:45] Speaker 1: the public to see what was happening behind the asylum walls. Gradually,
[46:51] Speaker 1: laws were passed to inspect institutions, limit restraints, and fund
[46:56] Speaker 1: alternative care. By the 1960s, the introduction of effective psychiatric
[47:04] Speaker 1: drugs and the growing public condemnation of the conditions led
[47:09] Speaker 1: to deinstitutionalization, the mass release of patients and closure of
[47:14] Speaker 1: many old hospitals. The brick walls that once held thousands
[47:19] Speaker 1: now stood empty or were demolished. It's telling that the
[47:25] Speaker 1: chief victims of the asylum abuse were society's most vulnerable,
[47:29] Speaker 1: the poor and marginalized, who had nowhere else to go.
[47:33] Speaker 1: Wealthier people could often keep afflicted relatives at home or
[47:36] Speaker 1: in genteel private sanatoriums, thus sparing them the worst of
[47:41] Speaker 1: the indignities. Walking through the overgrown ruins of a place
[47:45] Speaker 1: like Danvers State Hospital, or visiting the preserved former cells
[47:49] Speaker 1: today at Bedlam Museum, one can't help but feel a chill.
[47:54] Speaker 1: The voices of the past, the screams, the pleas, and
[47:57] Speaker 1: the silent tears, they still faintly echo. They are just
[48:02] Speaker 1: to remember the humanity of the vulnerable. The crumbling walls
[48:07] Speaker 1: of Danvers State Hospital, or the preserved cells of Bedlam's Museum,
[48:11] Speaker 1: still stand as a memorial to those who suffered. And
[48:15] Speaker 1: even today, the word Bedlam survives in our own language
[48:19] Speaker 1: to mean chaos, a linguistic ghost of the real legacy. Well,
[48:28] Speaker 1: thank you very much for listening. joining us today. It's
[48:34] Speaker 1: been a bit of a grim one, but I think
[48:41] Speaker 1: we had fun. I don't know. Did we? Maybe we did.
[48:45] Speaker 1: At least we learned something. Well, I will thank my
[48:48] Speaker 1: top tier patrons and supporters on YouTube and Patreon. Dark, Kimberly, Christine, Sally, Amber, Susan, Cameron, Legitimus, Kerry, Charlene, Lynn, Therese, Katiana, Nicholas, Ulfinier, Alexander, Charles, Christine, Dr. Neuronerd, Erin, Jaden, Jim, Jeffrey, Jessica, Madeline, Melissa,
[49:11] Speaker 1: Orthodox Review, Scott, Stark Factory, Shell, Wendy, Josie, Sarah, Ryan, Thor, Cameron, Stefan, Kevin, HMSHH, Crystal,
[49:22] Speaker 1: and Dalvery. Thank you so much. And I will see
[49:27] Speaker 1: you in the next episode, I suppose. Do we call
[49:32] Speaker 1: them episodes? I don't know. Either way, thank you for listening,
[49:36] Speaker 1: and lots of love to you all.

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