Transcript for:
Exploring the Dark History of Bedlam

Bishopsgate, the City of London Nearly seven centuries ago, it was here that the world's most notorious madhouse welcomed its first inmates. It was a place infamous for cruelty, abuse and violence. A place which even today is a byword for chaos and disorder. Bedlam. Lunatics!

Lunatics! Now, over 600 years later, under the bustling streets in the heart of the city, archaeologists are uncovering hundreds of skeletons, some of which came from this most dreaded of institutions. What might these remains tell us about the terrible abuses that went on behind the asylum walls?

We're going through the cell doors to unlock the fearsome secrets of Bedlam. Today, the streets around Liverpool Street Station lie in one of the busiest parts of London, its financial and business hub. But centuries ago, this was a run-down area on the edge of town, not far outside the old city walls.

It was deemed a suitably desolate spot for the construction of the original Bethlehem Hospital, or as it soon became known, Bedlam. By delving into the institution's historical records and following a new archaeological dig, we'll discover what life was really like inside Bedlam. We'll reveal the stories of some of its most deeply disturbed patients. And even sampled some of the so-called cures on offer inside. That's actually biting now, isn't it?

Ooh! It's a story that shows just how dramatically our attitudes to madness and the mad have changed throughout history. Nothing now remains of the original medieval Bedlam building. But behind these anonymous blue hoardings on Liverpool Street, archaeologists have recently uncovered a 16th century graveyard.

Are you ready, Tony? Have you got home, please? You may be wondering why I've got this Guantanamo fashion jumpsuit on. Well, this is... Do this first.

This is real urban archaeology. That's lovely. Just slacken it off a bit. There's rats, there's gas, and if anything goes wrong, then they're going to have to drag me out like that.

The graveyard was built alongside the medieval bedlam, and it's been uncovered during construction work for London's new crossrail link. This trench is just one of many being opened up as part of a major ongoing excavation. It may be restricted in size, but within its tight confines, archaeologists are uncovering dozens of burials. Come on, this is a nice little site, isn't it? It's a pretty challenging location.

We're in the middle of a major road in a very busy part of the city. We've got really tall buildings all the way around us and we've just got to make sure we don't undermine mine them for a start. So what have we got here? Well, we're in the middle of the cemetery.

We've got several graves here, and what you've got is some that are overlapping, some that are intercutting. This one's probably cutting through the legs of this, this lower one and this one's been very disturbed by a burial above. Makes it look like there was quite a lot of pressure on the graveyard doesn't it?

Yes it was here for about 150 years so they probably started off burying them in nice rows and they'd stack burials on top of each other until they got as close to the surface as was healthy and then they'd have no option but to dig through old burials to get new ones in. I know you're not going to like this question. But what are the possibilities, do you think, of us finding Bethlehem patients? Some of these burrows will be from the hospital. Potentially, we could find nameplates on a coffin, perhaps.

You know what I keep thinking? All those people in the buses just a few feet above our heads have no idea that just below them there's this great tumble of skeletons. MUSIC PLAYS Bethlehem, short for Bethlehem, was founded in the 13th century as a religious order. Named after the church, Bethlehem was the first church to be built in the 13th century.

Built on the site of Christ's birthplace, the guiding star of Bethlehem was to be its emblem. The Priory soon evolved into a prototype hospital, where monks helped care for the city's sick, poor or homeless. And by the late 14th century, Bedlam, as it was by then known, was starting to specialise in the treatment of lunatics. They were usually called lunatics.

There was a sort of technical legal term, lunatic, at that point. But they probably included all kinds of people who today we wouldn't say were suffering from mental illnesses. So perhaps people with learning difficulties or epilepsy, you know, brain tumours from injuries, or personality disorders, as we call them today, people who just couldn't cope with living in society and fell through the cracks.

Madness was a matter of behaviour, so it was classified rather in terms of sort of raving or furious madness on the one hand and melancholy madness on the other. Time Team's Alex Langlands is meeting Richard Barnett, historian of London's medical past, to learn more about how these unfortunates were treated in the early Bedlam. When I think about Bedlam, I think of actually quite a large institution. Is that the case? No, what we think of when we think of the big Bedlam is the 18th and 19th century Bedlam, when it did become a much larger and more modern kind of asylum.

In the medieval period, we're really talking about something rather like a small monastery, and we've got some rather nice evidence of this from a survey conducted. I've got a map here to show you. It certainly does show us that Bedlam is very small. It's a stone building. We've got a...

maybe 20 rooms here, something like that. Rooms that we could imagine being used for the confinement of the lunatics. It's very, very basic. If you imagine in winter, no fires, you would have wrapped yourself up in straw and rags and got on with it as best as you could. And it's only at its peak got about 30 or 40 inmates in it.

So it's very, very small. And in the individual rooms, what have we got then? Beds and...

Beds, if you're quite lucky, there are some reports from various surveys and visitations that the beds are rotten and that they have to be thrown out and replaced or that other inmates are literally just sleeping on straw. Inmates are confined to, sometimes to cells, other times to sort of wooden cubicles and shared dormitories. There would also have been restraint points on the walls. That's a rather crucial point, so that if anybody did get out of hand, they could be restrained.

So you would actually have had people, the people here with mental illness, being actually physically fastened to walls so they couldn't move? Yes, absolutely. Restraint is a crucial part of the culture of early bedlam. So it appears that Bedlam soon abandoned the good intentions of its founders and became more like a prison than a hospital.

Well, it would have been absolutely hellish, because the patients had come to Bedlam hoping that this was the one place. In London in the country in the world they could find respite and care Only to discover that their food was taken away from them and sold on their clothes were taken off their backs the straw from the mattresses the very Beer and bread which they should expect to eat Was taken away from them. They really had found themselves in the inferno But we're severely hampered in our quest to better understand the lives of these early inmates.

Owing to a lack of records, it's not until as late as the 16th century that we get our first glimpse of named individuals being admitted to the madhouse. This book represents the first historical record. that we have of the patients in Batham. This dates from 1598, and we have a list of about 21 patients that is coming as a result of the governors doing a spot check here to really check on, well, who have we got still here? And actually, more importantly, who's paying for them?

How long do people go in for? Typically, in many of these cases, we are actually seeing individuals who have been in sometimes for 10 and 20 years. At the top here, We have Elizabeth Dicombs sent in at the request of the parishioners of East Ham in Essex.

So this really is a pauper, isn't it? This really is a pauper. This is the typical patient that Bethlehem is receiving. But of course that doesn't tell the whole story. In addition, we have patients being supported by the aristocracy, including this interesting case of Barbara Heron, who is sent in by the Lady Stafford.

and is allowed for by her. So, to some extent, Bedlam is reflecting a range of different social classes, a sort of microcosm of London. But this is the forgotten microcosm, isn't it? The notion of these commissioners going into Bedlam and actually having to record who's there and who's paying for them because they don't know is terrifying.

Absolutely, there is a sense of anonymity written in to these patients. It's a whole book full of tragic stories. So it seems that rich or poor, lunatics dumped at Bedlam were hidden away and forgotten.

And doctors'attempts to treat madness didn't make life any more bearable. Alex Langlands is volunteering to try out some early bedlam medicines. Hello, Karen. Hello, Alex.

Nice to meet you. What are you making here? I'm making a prescription. He's joining herbalist Karen Howells to prepare a laxative.

OK. What's our first ingredient? The first thing is the buckthorn. bark.

Right, okay. So this is just an everyday hedgerow species, which you've bark stripped, you've got it in the mortar here, and you're grinding that down. Yeah, and the next thing is the acacia gum. We know maple syrup, it's from a tree. Yeah.

We would add to this then the infusion of senna. This is what you might recognise more easily is a senna pod. Yeah.

Traditionally used in making laxatives with milk. And we would infuse it. Infusion is just boiling that up with water.

Put in a tiny bit of that. And then you would stir this round. Yeah. And, of course, that's your prescription made. It smells very medicinal, actually.

It smells actually quite nice. Yeah. You imagine that it clears the body. And this should clean. your melancholy, you know, like this should deliver you a nice purge.

OK, so if I were to give this just a smallest try here... It's very brave. Very brave, you think?

You do have toilets here, don't you? Yes. And that is actually disgusting.

It's really, really disgusting. It seems to me absolutely bizarre that for treating, say, lunacy and madness, that you're using these substances which cause people both diarrhoea and vomiting, but I guess in that whole process you're actually sedating them. Yes, this would be a regime that could exhaust you to the point of where you're quite debilitated. But worse could follow. Beatings also formed a key part of Bedlam's treatment program.

Little wonder it became the most notorious madhouse in history. It seems totally barbaric to us that you can cure somebody by chaining them up, beating them, and having them lying vomiting in their own filth. To us it seems like a sadistic form of punishment. What were the doctors at the time hoping to achieve with this treatment?

Did they really think these brutal methods could actually help to cure lunacy? Back in the 14th and 15th centuries, the explanations for madness were very different to those of modern medicine. The general feeling at this point in history was that madness was caused by demoniac possession, and that if you fell mad, you were basically being possessed by evil spirits.

And if you were unfortunate enough to go mad, the very last place you'd have wanted to end up was London's Bedlam Hospital. It was notorious for a brutal and humiliating approach to treatment and most of the cures on offer would have been extremely unlikely to have done you any good. In fact, quite the reverse. If you weren't mad when you went in, a spell in Bedlam could easily have been enough to send you over the edge.

To drive out the evil spirits, it was customary to bind or tie up the patient and then to beat or whip them. Until they believed spirits had gone. Unfortunately, this quite often coincided with life being extinct as well, so it was by no means a satisfactory process.

Beating wasn't the only cure on offer, though some of the alternatives were equally unpleasant. Alex Langlands has offered himself up as a human guinea pig and is testing out a range of early mad cures. He's starting with a little light bleeding. Are you comfortable? Could you be here for a bit of time?

I'm sort of comfortable. I've given blood before, but of course not in this way. Yeah, but you've got to sit comfortably. Right. Okay, then right, here we go.

And we just wait for our little friend now to come down. Now, oh, now something's happening. I think he's going.

Right, I'll take the glass away. Actually, that's actually biting now, isn't it? Yes, you'll feel it. I say it feels like a small Chinese burn.

Yeah, oh yeah. But that will go off. That is actually a bit of a sting there.

Yeah, that will go off. Because what's happening now, sorry to say this, he's spitting into the wound. This will anaesthetise the wound.

It will stop the blood congenitally anticoagulant. But more importantly, around the area, the capillaries are being paralysed till they stay open. So that's just going to bleed and bleed and bleed and allow the leech to just really feast itself.

Yes. Doctors at the time... would apply anything up to 50 leeches in one go.

And in just half an hour, a single leech can drain as much as 60 millilitres of blood, nine times its own body weight. He's really troughing now. He's getting it down his neck. Yep.

Now, what effect did physicians and doctors at places like Bedlam believe that bloodletting was having on the body? Well, they believed that taking the blood from you was good for you because it was a part of the four humours. When the four humours become out of balance, you become ill or unwell. I would say you're at dis-ease with yourself.

And the only way that they balanced them up was by getting rid of the excess. So madness, then, wasn't being seen as a problem that was to do with the brain. It was really just being treated like any other disease.

Yes. If you're mentally ill, it's an imbalance of the humours. So we have to balance everything back up again. So demonic possession wasn't the only explanation for madness in the medieval world.

The theory of the four humours was actually the key medical concept of the age. It suggested that there were four vital bodily fluids. Blood, phlegm, yellow bile and black bile. There were certain humours out of the four which were said to lead to madness. For instance melancholia.

It was believed to be the result of too much black bile or anger, too much cholera or choleric or red bile. The theory completely dominated medical thinking from the time of the ancient Greeks, right through the medieval period and well into the 18th century. In seeking to restore the balance of the humours, doctors favoured treatments like bloodletting.

And while leeches were certainly one possible prescription, for most bedlam patients, they'd have been an unaffordable luxury. Say we don't have access to leeches, what sort of other equipment would we use to bloodlet? The most common way to bleed somebody, of course, is to just use a knife, and we'd cut them. Really?

Great to start the bleeding. Bit of a problem to stop it, though. A large cup full of blood could be taken from a patient in a single bloodletting session, sometimes much more. Now, my personal favourite, I'm sorry about this, is the fleam.

This one, you lay on the area you want to bleed. yeah and then you walk it really hard with a hammer Wow and then by twisting the blade you can then control bit of blood on top that's painful that's right now you understand why leeches I don't sound too bad why these are top of the market top of the market another favored treatment also based on the idea of the four humors was blistering the application of caustic substances to the skin the idea was to create infection that would then draw out bile from inside the body. We now know that the theory of the four humours has no basis in fact, so the Bedlam doctors'treatments would have had little or no therapeutic effect.

They were not for the benefit of the patients, they were for the benefit of the people who were looking after them, who were trying to manage this collection of people who were really just sort of sitting around vegetating. You had to do something with them. and these treatments kind of kept them docile, and they were also the kind of treatments that, you know, could be withheld for patients with good behaviour and doubled down on for patients who were behaving badly. And when these treatments finally proved too much to bear, you'd have likely as not ended up here, our dig-site graveyard. Time Team's Jackie McKinley is meeting historian Vanessa Harding to examine the local burial records.

Vanessa, you've got to hear the parish registers. that cover the area of the bedlam hospital can we get any impression from the documents of what life was like in the hospital well we actually get the rather surprising impression that there were small children there because for example we've got an entry here on the 5th of november 1591 an infant from bethlehem buried and that's then immediately followed by catherine from bethlehem buried on the same day So that sort of gives the indication that Catherine may have been the mother of the child. I think it's quite likely. This was a death in childbirth.

Yes, but about a hundred years later there is a well-reported case. which an attendant is dismissed for having impregnated a female patient and that it's not just that problem because at about the same time it certainly looks as though a far higher number of male attendants or basket men are being dismissed for misconduct than female gosh so I mean these would potentially very vulnerable young women going into places like this will open to abuse I'm afraid so yes yeah Can you give me any idea of the numbers of people buried there? Surprisingly, yes. The total number of lunatics from the hospital being buried in the churchyard could be several hundred. That is really quite surprising.

I wasn't anticipating there being quite that many. many of them. It is indeed, yes. If we start with this one, we have Humphrey Cantrell, lunatic, buried at Bedlam.

Thomas Wells, lunatic, buried at Bedlam. Mary Pender, lunatic, threw herself out of a window. Good grief. So the parish records reveal there's unlikely to be a shortage of Bedlam patients buried on our dig site. With over 300 skeletons already recovered, it's almost certain some were patients who'd fallen victim to Bedlam's harsh regime.

But will any of these remains bear physical marks that could single them out as belonging to madhouse patients? Well, the only way to find out is by examining them. And in this rather unprepossessing building in Shoreditch called Mortimer Wheeler House, experts are looking at them right now.

Jackie McKinley is catching up with the Museum of London's bone experts. Jackie, I know that none of these skeletons are going to have been excavated with signs around their necks saying, I am mad. But is there any way that we can ascertain whether any of these people might have been inmates of Bedlam? Well as you quite rightly say, actually seeing evidence of madness as such on skeletal material is not going to happen.

But there are some diseases which in particular in later stages can lead to mental disorders and this indeed is a case in point. Now if I put that next to it there you can see, because this is the thigh bone, this is what it should look like and as you can see, see this one is much thicker there's been new bone formation and it's not smooth this is all bone reaction to infection so what do you think you might be seeing him well it's the characteristic distribution of these lesions that give us a clue and that And the distribution of these lesions in particular suggests a specific infection such as syphilis. Ah.

And what's the link between syphilis and bedlam? Well, syphilis is one of those diseases that in its late stages, because it affects the nervous system and your brain is full of nerves, you can get mental disorders linked to the disease itself. But with syphilis, we also know that the treatment of syphilis could also have caused madness because one of the treatments...

was mercury now if you get enough mercury in your system it will cause delusional behavior you could be overexcited ball agitation agitation insomnia erratic behavior and that of course would make you appear like you were mad now what we don't know in this particular instance is whether this person might have been in bedlam because of the madness that they apparently had or there might have been when one of the two hospitals are in London that dealt with venereal disease that's a very very It's a very good candidate for being a bedlam patient. The main visible symptoms of syphilis are bodily ulcerations and skin lesions. But in its final phases, regardless of whether mercury is being prescribed, patients can suffer dementia, a form of mental illness. So finding a victim of this disease in our graveyard is a real breakthrough for the archaeologists. It means their investigations...

are already suggesting possible links to Bedlam. As time went on, conditions for the asylum inmates seem to have gone from bad to worse. The fabric of the building itself was growing ever more decrepit.

But in the second half of the 17th century a dramatic event was about to sweep away much of medieval London and the decaying Bedlam madhouse was also about to be transformed. In 1666, one of the most momentous events in London's history helped transform Bedlam Hospital. The Great Fire of London devastated whole swathes of the city and the Bedlam governors were forced to meet.

at the hospital in Bishopsgate. What they saw there so shocked and horrified them that they decided a new hospital was needed. So Bedlam was rebuilt, just a short walk away from the site of the original hospital.

But unlike the old hospital, this new incarnation was a grand and imposing building. Bedlam seemed ready for the scientific revolution of the century ahead. New medical theories were starting to emerge, and new explanations for madness were being sought. This is part of a sense that the body is an instrument with different parts that are designed to do different things.

And the beginnings of the idea that... You know, thought and mental activity all take place in the brain and there must be something in the physical structure of the brain that's producing thoughts and something that's at fault in the physical structure of the brain that produces the disordered thinking associated with madness. Intriguingly, in the Museum of London, there's evidence of 18th-century doctors'attempts to seek out the source of madness within the brain.

It looks like they must have suffered from... Quite a headache. We found a fragment of a frontal bone that had a clean saw cut running across it, suggesting that the person had undergone an autopsy or craniotomy. And has that happened here? Well, as you can see, that's exactly what's happened here.

The top of the head has been cut off. And that's because doctors were examining the inside of the skull. They wanted to have a look at the brain. So what you've got to bear in mind here is that we are now at the edge of the age of enlightenment. Prior to this time, mental illness was viewed as either something being wrong with the humours or some kind of demonic influence.

They weren't going to accept that any longer. They wanted to see if there was any physical... reasons why somebody would behave in a mad way.

So you're saying you found evidence from our graveyard that this kind of investigation was being practised here, so it seems that there were doctors who were looking at dead bedlam patients trying to interpret what their madness actually meant. It may well be the case. We can't prove whether or not the skull belonged to a Bedlam patient, but we do know that from the late 18th century on, post-mortems were performed at the hospital. Apothecary John Haslam was a particularly enthusiastic dissector, publishing a detailed study of his research, Observations on Madness.

And the new science led to some high-tech approaches to curing madness. At least one still used today to treat depression. Hello Richard.

Hello Alex. I've come for my electrotherapy. Oh well, welcome to the sweet reasonableness of the 18th century. Very different from bedlam where we found ourselves earlier Yeah, it's all seen so far very sort of barbaric some of this treatment of mental illness, but we move into this period We're looking at things much more sort of on the scientific side. Oh, absolutely.

Yes I mean we find ourselves in the age of reason in the 18th century. This is an age, first of all, of new anatomical discoveries about the nervous system. By the end of the 18th century, it's very clear to a lot of European doctors and natural philosophers that the body, and especially the nervous system, runs on electricity in some sort of way.

And what we have here is a Hawksby machine. It's an absolutely standard piece of kit by the 18th century as a way of generating static electricity. So is this the sort of technology then that physicians and surgeons in places like Bedlam would have been using? Yes, absolutely, we do have records of this kind of machine being ordered for use in Bedlam.

and a lot of the physicians who worked in bedlam in the late 18th, 30th, 19th centuries were very interested in electrotherapy. Now, this is all very well, but how is it actually being used to treat madness? Well, as with bleeding, this could be applied to any part of the body. If you had a physical ailment in your foot or in your abdomen, you could use a wire to connect it to that, or you could apply the affected part to the end of the brass cylinder. So this really could be applied to any part of the body that's affected.

And, of course, if you're thinking of a mental illness, it's the head, it's the brain that you're going for. So what's happening there? then is we're seeing the critical link being made between mental illness and the brain exactly so it's going from being at an older sort of humoral holistic vision of madness or something that's kind of distributed throughout the body to something that's being focused on a smaller and smaller bit of anatomy so if you care to apply Whichever part of your body you like to the end of the cylinder there. Okay, we'll start with the finger.

So I'll start cranking it here. This will start building up the shock which will travel through the cylinder. So we're waiting nervously. Ooh, that's quite strong actually. Care to try it again?

Yes, go on then. Okay. Oh, excellent stuff. Already, I feel restored, Richard.

Good, I'm very glad to hear it. To fine health. So I'll be back next week for my next bout of treatment. And I'll send you my bill.

Thank you very much. Most welcome. But in practice, the 18th century science...

revolution made little impact on life at Bedlam the madhouse remained firmly rooted in the past conditions at the end of the 18th century would have been incredibly grim for the majority of patients there are accounts of women crouched naked in the straw chain to the walls of patients developing gangrene on their legs where the chains of their manacles had rubbed against the flesh widespread lice fleas, starvation, beatings, food stolen by harsh uncaring wardresses. And in terms of treatment, restraints and purging were still the order of the day. Not to mention other archaic cures such as cold baths and spinning chairs, all designed to literally shake people out of their madness.

Dishing out these remedies was a medical family who over four generations became the most notorious mad doctors in Britain, the Monroes. It seems quite outrageous nowadays, doesn't it, that the most senior figure in Bedlam should be the father, then the son, through generations. It does, and of course it leads to genuine problems, suggesting that it's one family monopolising madness at the most significant institution in the country.

And of course there was no NHS in those days, so they would have been making money out of their position. Absolutely. It's a great number, because you are the mad doctor of the most famous hospital in England, and there is a generation of custom coming to the Munro's and the private madhouse.

So even though they didn't get that much money from Bedlam, because they were the chief of Bedlam, that attracted private patients to them, so indirectly they were making a lot of money out of it. That's absolutely true, and the wills of the family show that they generated a huge amount of income through their private practice. Perhaps the most infamous of this dynasty was James Monroe.

The story of one of his private patients, Alexander Crudden, reveals much about his outdated approach to the treatment of madness. Crudden was apparently plucked from the streets of London on the instructions of a romantic rival. Whisked to Monroe's private madhouse in Bethnal Green, he was cuffed, manacled and force-fed medicines. Crudden all along denied that he was in any way deranged and complained that Monroe had prescribed drugs six days before even seeing him. Stories like Crudden's of people being locked up in madhouses as part of a plot or conspiracy or abuse in madhouses.

These were great tabloid fodder in the 18th century because they usually led back into really juicy family dramas. You know, maybe some husband had locked his wife up as mad because he was having an affair with somebody else or because he was after her inheritance or something. But Bedlam's medical malpractice was hardly hidden away behind locked doors. Incredibly, as a way of bringing in more cash...

Doctors actively encouraged public tours, turning the hospital into a shocking freak show. I think there was a strong element of voyeurism, that people wanted to see these degraded and stupefied victims. There was an element of cruelty about it, and there's an element of making fun at the expense of the misfortunes of others.

One of the very few depictions of the interior of Bedlam dates from this time. The final panel of William Hogarth's masterpiece, The Rake's Progress. It shows polite society ladies enjoying their day trip to the madhouse.

But public fascination with madness reached fever pitch later in the 18th century with the case of the most famous lunatic in all of British history. In 1788, King George III suffered from the first of several episodes of insanity and his family brought him here. At Kew, the king was locked up against his will, forcibly restrained, and subjected to a regime of blistering and bleeding. His madness may have been caused by the disease porphyria, but whatever the underlying condition, the progress of George III's illness unfolded like a soap opera, gripping the nation.

Was he deliberately being kept out of public view, do you think? Oh, I think that was very much part of the plan. And, of course, the king was not fit to be seen. Why?

What sort of symptoms was he displaying? Well, I mean, he was violent at times. He struck his pages, he burnt their wigs.

There was a lot of horseplay going on. He was very distressed. He had... bandages on his legs and his arms where he'd been blistered. Did they consult the people at Bedlam?

Dr Warren, who was the Prince of Wales'doctor, did actually take a consultation from Dr Munro of Bedlam as to whether it was possible that the King might recover. And Dr Munro's verdict was no. As far as he was concerned, the King was hopelessly insane.

But he did get better? He did recover. And there was huge, you know, sort of joy in the country and there were medals struck there was a huge and service at some pools there were illuminations in the streets what do you think the impact of the King being mad had on people generally I think when he recovered there must have been an awareness in the general population but it was possible and for people first of all to admit that there had been attack of madness and and to that it was possible to recover from an outbreak of madness and not be you know, put away in bedlam and never seen again. The king's successful struggle with insanity had a huge impact. While he went on to suffer relapses, the public started to see madness as something that could be successfully treated by modern medicine.

Bedlam, with its outmoded barbaric practices, would find itself increasingly under pressure to change. Here in Bishopsgate in the City of London we're taking an early look at a major ongoing excavation into Bedlam Graveyard. Behind these hoardings the secrets of the burial ground that once stood alongside Britain's most famous madhouse are gradually being revealed. How many skeletons have you identified so far in this trench?

Well, within this small area, we've dug down from about here. We've already taken out in the region of 35. So it was a pretty crowded cemetery. What we've dug so far probably accounts for maybe 4 or 5%. The cemetery was in use for about 150 years, and we expect to find several thousands. And what's this lovely thing here?

This is a bead necklace we found with one of the skeletons. It's an infant burial. That was actually worn by the person who was buried?

Yes, there's been nothing else within the coffins apart from this. It's quite crude but charming as well, isn't it? I can imagine that the little child would have valued that.

Any other finds? We have traces of potential nameplates. Frustratingly, they're so badly corroded and fragmented that getting a name off them is nearly impossible.

This would have been a big investment for some loving relative wouldn't it the handle and the name plate and now this is all that there is left. It remains to be seen what more the dig will uncover as the search continues for evidence of links to bedlam patients. By the 18th century, the madhouse was reaching the peak of its notoriety.

Its brutal treatment of patients was looking ever more outdated. With Bedlam and its doctors coming... More and more under attack, a pioneering new institution was established here in York.

It was called the York Retreat. It was set up by a Quaker reformer called William Tuke and it had a very different philosophy from Bedlam. The York Retreat offered an alternative to Bedlam's regime of restraint and abuse. What was the f- philosophy of the York retreat it's beautifully set out in this book written by William Duke's grandson Samuel published in 1813 he proposed to set up a building sufficient to accommodate 30 patients in an airy situation at a short distance from York there may be a few acres for keeping cows and garden ground for the family which will afford scope for the patients to take exercise when that may be prudent and suitable It's a little rural idyll, isn't it?

A rural idyll. It sounds like there was a big ideological difference between the people who were running Bedlam and the people running this place. Um, totally.

Samuel Toot believed that there is a bit of God in everyone and that if we appeal to the good in everyone and we look after them and nurture them and train them, they can be brought back to good mental health. Whereas the Monroes were what we now call therapeutic pessimists. They believed that madness, as they called it, could only be managed...

that it couldn't be cured and that all you could really do with your patients was lock them up and throw away the key how significant do you think the York retreat was it set the bar really for subsequent asylums and it was one can almost say a revolution in care for the insane in those days The new approach pioneered at York proved hugely successful. Around 40% of patients were restored to good health in its first years of operation. In comparison, Bedlam looked like a relic from the past.

One reforming MP, Edward Wakefield, set out to expose its abuses. One of the most notorious cases he uncovered was that of James Norris. An American sailor, Norris was chained up for over ten years.

Yet according to Wakefield, he seemed perfectly sane. An engraving of Norris, depicting his brutal treatment, was widely published and led to popular outrage. And it came hot on the heels of another disturbing case.

A patient by the name of James Tilley Matthews, who appeared to be in the grip of powerful delusions. He believed that a revolutionary cell, the air... had built an elaborate contraption in the basement of the House of Commons.

It sent messages through the air, controlling the minds of leading government figures. Tilly Matthews'symptoms conformed to what we might today describe as paranoid delusion. Yet few believe that this highly learned individual posed any danger to himself or others. Why did the Tilly Matthews case become such a core celebrity? Because he stands in contrast the popular belief of what a mad person was because he's educated and articulate.

But he's got the skill to produce very detailed drawings which could convince people that there was something behind what he was saying. High-profile cases like these... ratcheted up the pressure for change at Bedlam.

They captured the popular imagination. I think people could identify either with Norris or Matthews. There were two different types of people, a seaman, a tea broker.

And because both of them appear to be treated so brutally and so unfairly, they're both used by reformers to expose shortcomings in the treatment and management of mentally ill patients. Eventually, in 1815, a parliamentary investigation into Bedlam was set up. It proved so critical that it finally brought about the downfall of the notorious Monroe Mad Doctors.

They're old-fashioned consulting physicians. Silver-haired men with black hats and silver-topped canes at the top of society. society and they believed that they were right.

There was a kind of arrogance about the Monroes which started off as confidence and then became atrophied so that after three generations they became blinkered, narrow-minded and in the end downright dangerous. Following the inquiry Bedlam relocated once more to the building that today houses the Imperial War Museum. It was the beginning of a new era which would see the first signs of a modern and humane therapeutic regime.

Although the Bedlam dig still has a long way to go, bones from the graveyard are already giving us new insights into its past, helping us understand how the story of the infamous hospital reflects society's changing attitudes to madness and the mad. But in the end, I can't help wondering how much we really understand even now. Because if there's one thing I've learned, it's that just as these bones still contain their secrets, then so does the human mind, which for centuries doctors and scientists have tried to unlock and are still attempting to do so, even today.

Oh! Oh! Tonight, Channel 4 is celebrating 50 years of rock excess with a special rock night. It's starting in 10 minutes time, 10 past 10. And here on More 4, we have a classic of our own involving a hairy milkman and a young impressionable priest in Father Ted.