Find your ancestors in London, Bethlem Hospital Patient Admission Registers and Casebooks 1683-1932

Bethlem Hospital, 1707

Each record will include a transcript and most will include an image of the original document.

Transcript

The details in each transcript will vary depending on the type of document the information has been taken from. In a transcript you may find:

• Name
• Birth year
• Age
• Occupation
• Residence
• Role – whether the individual is a patient or a member of staff
• Event year – year the information was recorded
• Admission year
• Death or discharge year – these dates were often recorded in the same column therefore it is best to view the image to discover if the patient died or if he/she was discharged from the hospital. A discharged patient does not always imply that the patient was sent home, in some cases they may have been sent to another institution.
• Book year
• Hospital
• Archive reference
• Series
• Type
• Year range – of the volume

Image

To get the most out of the records it is always best to view the image. There are various types of records available therefore the information in each record can vary. You may find your ancestor in more than one record type. Below are the different types of records available and the information you can find in each:

Admission register (Reference ARA)

• Throughout the history of Bethlem hospital the registration book and the amount of information found in the books have continuously changed.
• The earlier volumes are primarily lists of the patients with their admission date, last known address, discharge date, in some cases a reason for discharge was given, and names of securities – those either paying for the patient’s stay in the hospital or those to be contacted if payment was not made.
• After the 1840s the register books became more sophisticated and structured. They recorded far more detail about the patient such as marital status, occupation, age, education and who brought the patient to the hospital: usually a family member or friend.
• The later records also include additional notes about the patient’s discharge, such as whether they were recovered, not well or on a leave of absence. If the patient has died some records include a cause of death.
• Some of the volume dates overlap and the entries can be duplicated.

Incurable Patient Admission Registers 1723-1919 (Reference ARB)

• Earliest records include name, securities and discharge or death date.
• Some of the books will separate the patients’ names by male or female.
• The latest book, ARB-04, is more structured and records information about the patient’s illness or disorder, physical health and reasons for discharge.

Female Voluntary Patient Admissions Registers 1890-1910 (Reference ARC)

• The voluntary patients are uncertified patients that have voluntarily admitted themselves to the hospital.
• The records include a table which registers date, name, term for which residence is permitted, extended term and date of consent to extension, names of commissioner of visitors consenting to reception or extension of term, name of persons signing the request for reception – usually a relative, date on which the boarder leaves the hospital and other remarks.

Criminal Patient Admission Registers 1816-1864 (Reference ARD)

• There are two books within this series.
• Within the records you will find admission date, name, age, address or previous institution, crime, verdict, when and where tried, condition of life, discharge or removal date.
• The second of the two books gives more detail about the patient and the judgement of the court. For example, it registers if the patient was found insane by jury, acquitted because insane or committed by justices.

Minutes of the Court Of Governors 1559-1689 (Reference BCB)

• The governors met every two to three weeks.
• Each meeting record begins with the date of meeting and names of those in attendance.
• The governors were responsible for the appointment of all the staff and deciding on their set salary.
• They also managed the hospital properties and the finances.
• In some meetings they would discuss the behaviour of particular patients.

Patient Casebooks Covering the Dates 1815 To 1919 (Reference CB)

• All the casebooks begin with an alphabetical index of the patients’ names
• Description of the patient and admission date
• Observations of behaviour such as violent, good or bad appetite, frequently praying, sleep patterns, etc.
• Books after 1909 are better structured and contain more information about the patients. Including: name, admission date, residence, profession, marital status, number of children, patient’s father and spouse, religion and age (may be estimated).
• The 20th century books recorded a mental health history – dates of ‘attacks’, previous hospitalisation, supposed cause of insanity and family history of mental health.
• You will also find the medical examinations including behaviour and physical examination and descriptions.
• Finally you will find one to two pages of monthly (or in some cases weekly) observations of the patient’s progress.

Male and Female Patient Casebooks Covering the Dates 1903 To 1913 (Reference CWA)

• Records are from Warlingham Park Hospital (formerly Croydon Mental Hospital). Inserted in the cover of each casebook is the ‘Rules of the Commissioners in Lunacy (26 June 1895).’ The casebook begins with an alphabetical index of the patients’ names.
• Many include a photograph of the patient.
• The books are in a structured format with an initial medical certificate which includes: admission date, nationality, religion, education, whether transferred from other asylums, age at admission, marital status and profession.
• Questions related to mental health ask the dates of ‘attacks’ and duration. You will also find diagnosis at admission and whether the patient is epileptic, paralytic, suicidal or dangerous.
• The doctor’s notes of the initial examination and information given to the doctor by others; such as family or friends at admission.
• Details about the ‘present attack’ such as how long has the mind been affected, any signs before the attack, any loss of appetite or sleep, any religious or sexual excitement, any cause for the attack – a fright, family trouble, poverty, drink, shock, etc. and where was the patient born and where has the patient lived.
• Records the patient’s own mental health history and the known history of the patient’s family.
• Full physical examination including physical description, general health and notes on the patient’s speech, attention and memory.

Male and Female Private Patient Casebooks Covering the Dates 1903 To 1913 (Reference CWB)

• Records are from Warlingham Park Hospital (formerly Croydon Mental Hospital). Inserted in the cover of each casebook is the ‘Rules of the Commissioners in Lunacy (26 June 1895).’ The casebook begins with an alphabetical index of the patients’ names.
• These volumes record the same information as the Male and Female Patient Casebooks Covering the Dates 1903 To 1913 (Reference CWA).

Discharge and Death Registers 1782-1906 (Reference DDR)

• Earliest registers are lists of patients’ names separated into men and women and the date they left the hospital or date of death.
• From 1802 onwards the register recorded more information such as, if the patient was healthy at discharge, leaving for temporary leave or incurable.
• After the 1850s the books are recorded in a set format. The register date of discharge or death, date of admission, register number, name, sex, class (whether the patient was a pauper), type of discharge (recovered, relieved or not improved), if the patient died, cause of death, age at death and additional observations. Also, includes a note if the patient was criminal.
• If a patient was discharged it does not mean that they were able to go home, some patients were discharged and transferred to other institutions. Others may have been on temporary leave.

Staff Salary Books 1777-1932 (Reference SB)

• Earliest records list staff by job title, full name and the amount paid in pre decimal currency; then the individual’s signature.
• Job titles include, but not limited to: Physician, Clerk, Surgeon, Apothecary, Steward, Porter, Matron, Basket Men, Assistant Basket Men, Maids, Gallery Maids, Laundry Maids, Cook and Accountant.
• After 1843 the records no longer include the job title of Basket Men. Instead there are Male Attendants and Female Attendants.
• After the 1900s the staff books include nurses.
• The more recent records include deductions for National Insurance introduced by the National Insurance Act 1911.

Discover more about these records

Bethlem Royal Hospital was founded in 1247 as the Priory of St Mary of Bethlehem and is one of the world’s oldest hospitals for the treatment of mental illness. In 1547 it came under the control of the City of London as one of the 5 Royal hospitals refounded after the Reformation, the others being Barts, St Thomas’s, Bridewell and Christ’s Hospital. From the 1570s, Bridewell and Bethlem were governed together, which can be seen in the Minutes of the Court of Governors records.

Bethlem hospital became known for scandal and intrigue through the centuries. It was popular in plays, literary works and Hogarth’s A Rakes Progress. Conditions in the hospital had become poor and ‘Bedlam’ become synonymous with madness and pandemonium. Bedlam came from the pronunciation of ‘Bethlem’ in the Jacobean era.

The original hospital was located near Bishopsgate, outside the walls of the city of London. In 1676 it was moved to Moorsfields, now known as Finsbury Circus, outside Moorgate. Everything from the original building was auctioned off except for the two famous sculptures of Melancholy and Raving Madness.

The new building was large and grand to impress the wealthy and well born visitors to the hospital. Until 1770, unrestricted visiting was permitted by the hospital governors – this resulted in the inmates becoming an attraction for the amusement of the public. It was a popular tourist site and was even listed in guidebooks. On the way to the hospitals you could find people playing games and selling pies. The wealthy could connect the grandness to what they knew of their own new stylish houses. Those visiting the hospital took the experience to be like visiting a zoo, patients were expected to ‘perform.’ Many came to the hospital because they desired to meet odd and eccentric people. However, due to the abuse towards patients and security, access to the grounds was restricted by 1770 to those who were given permission by the governor.

The records tell little of the treatments given to the patients. We do know that it was common in the 18th and 19th centuries to give patients cold baths or restrain them in strait jackets. Some patients were confined to their rooms. Other treatments included bloodletting or purges. Today, these methods seem archaic and even inhuman. However, these treatments were not unique to Bethlem and were used widely. In 1815 a parliamentary enquiry into the treatment of patients in institutions such as Bethlem led to reforms in the treatment and management of mental illness. In the last two centuries treatment of the mentally ill has vastly improved.

The hospital moved one more time before settling in its current location in Beckenham. In 1815, it was moved to St. George’s Fields in Southwark. The Moorfields location had declined from its grand state when it was first opened in the 17th century. Much of the building had fallen into disrepair. The new site was larger and gave the patients more space for outdoor activities including gardening. A new ‘moral therapy’ began and patients’ comfort was more of a priority than in the early days of the hospital.

In 1930, the hospital moved a final time to Beckenham, a suburb of London. The previous location at Southwark has now become the Imperial War Museum. Today, Bethlem Royal Hospital is at the front of humanitarian treatment for mental health and is a part of the South London and Maudsley NHS Foundation Trust.