ABSTRACT
The great defect of pre-modern Bethlem, it has been said, was indifference to its patients and its failure to develop new and effective treatments. From the physician-keepership of Helkiah Crooke to the physicianship of Thomas Monro (1792-I 8 16), disgraced and not elected after the public revelations of the Madhouses Committee inquiry (I 8 I 5-I 6), its medical regime has been pictured in a dismal light. 1 There is much truth in these criticisms, but it is also important to avoid anachronistic judgments. For instance, apparent proof of 'apathy' has been the failure of its physicians to publish on insanity until John Monro was forced into print in 175 8 by William Battie's criticisms.2 Yet it was exceptional for physicians in general in this period to publish the fruits of their hospital experience.3 Prior to the 17 50S, the majority of those writing about treatments for the insane were private practitioners, without hospital practice, quacks or clergymen. Indeed, until then, the fact that Bethlem physicians did not write books about their experiences was not a matter on which aspersions were cast.
