There is a rather well-grounded tradition that Sigibaldus, the thirty-sixth bishop of Metz during the papacy of Leo IV., about a.d. 850, erected two monasteries and paid special attention to the sick in body and mind. There are records that the insane in Metz were placed under the guardianship of persons regularly appointed. The attendants in the hospitals had to take a special oath of allegiance to the King, and that they would fulfil their duties properly.
* Burdett, " Hospitals and Asylums of the World".
There is definite evidence of Bethlehem in London, afterwards known as Bedlam, containing lunatics during the thirteenth century, for there is the report of a Royal Commission in the next century stating that there were six lunatics there who were under duress. Burdett says that Bedlam has been devoted exclusively to the treatment of lunatics from some years prior to 1400 down to the present time, so that it takes precedence in this matter of the asylum founded in Valencia in Spain, which Desmaisons has erroneously held as the first established in Europe. Esquirol states that the Parliament of Paris ordered the general hospital, that of the Hotel Dieu, to provide a place for the confinement of lunatics centuries before this; and while definite evidence is lacking, there seems no doubt that in most places there were, as we have said, what we would call psychopathic wards in connection with medieval hospitals.
Early in the fifteenth century there are a number of bequests made to Bedlam which specifically mention the care of the insane. Indeed, " the poor madmen of Bethlehem " seem to have been favourite objects of charity. The care of the insane there seems to have touched a responsive chord in many hearts. Mayor Gregory describes in his " Historical Collections " (about 1451) this London asylum and its work of mercy, and from him we have evidence of the fact that some of the patients were restored to reason after their stay in the asylum. He has words of praise for how " honestly " the patients were cared for; but recognizes, of course, that some could not be cured. In his quaint old English he emphasizes particularly the church feature of the establishment.
" A chyrche of Owre Lady that ys namyde Bedlam. And yn that place ben founde many men that ben fallyn owte of hyr wytte. And fulle honestely they ben kepte in that place; and sum ben restoryde unto hyr witte and helthe a-gayne. And sum ben a-bydyng there yn for evyr, for they ben falle soo moche owte of hem selfe that hyt ys uncurerabylle unto man".
In her chapter on Hospitals for the Insane in " Medieval Hospitals of England,"* Miss Clay gives a number of details of the care of the insane in England, and notes that the Rolls of Parliament (1414) mention " hospitals ... to maintain men and women who had lost their wits and memory "; manifestly they had some experience which differentiated cases of aphasia from those of insanity. She says that outside of London " it was customary to receive persons suffering from attacks of mania into general infirmaries. At Holy Trinity, Salisbury, not only were sick persons and women in childbirth received, but mad people were to be taken care of (furiosi custodiantur donee sensum adipiscantur). This was at the close of the fourteenth century. In the petition for the reformation of hospitals (1414), it is stated that they existed partly to maintain those who had lost their wits and memory (hors de leur sennes et memoire).
* London, 1909.
Further evidence of the presence of the insane with other patients is to be found in the fact that in certain hospitals and almshouses it was forbidden to receive the insane, showing that in many places that must have been the custom. Miss Clay notes :
" Many almshouse-statutes, however, prohibited their admission. A regulation concerning an endowed bed in St. John's, Coventry (1444), declared that a candidate must be ' not mad, quarrelsome, leprous, infected.' At Ewelme 4 no wood man ' [crazy person] must be received; and an inmate becoming 4 madd, or woode,' was to be removed from the Croydon almshouse".
Desmaisons is responsible for the tradition which declares there were no asylums for the insane until the beginning of the fifteenth century, and that then they were founded by the Spaniards under the influence of the Mohammedans. Lecky, in his 44 History of European Morals," has contradicted this assertion of Desmaisons', and declares that there is absolutely no proof for it. Burdett, in his 44 History of Hospitals," vol. i., p. 42, says with regard to this question :
Again, Desmaisons states that the 4 origin of the first establishment exclusively devoted to the insane dates back to a.d. 1409. This date constitutes an historic fact, the importance of which doubtless needs no demonstration. Its importance stands out all the more clearly when we calculate the lapse of time between the period just spoken of (1409) and that in which Spain's example ' (Desmaisons is here referring to the Valencia asylum as the first in Europe) 4 found so many followers.' Now, as a matter of fact, an asylum exclusively for the use of the mentally infirm existed at Metz in the year a.d. 1100, and another at Elbing, near Danzic, in 1320. Again, there was an ancient asylum, according to Dugdale, known as Berking Church Hospital, near the Tower of London, for which Robert Denton, chaplain, obtained a licence from King Edward III. in a.d. 1371. Denton paid forty shillings for this licence, which empowered him to found a hospital in a house of his own, in the parish of Berking Church, London, 4 for the poor priests, and for men and women in the said city who suddenly fall into a frenzy and lose their memory, who were to reside there till cured ; with an oratory to the said hospital to the invocation of the Blessed Virgin Mary.' "
The passages from Aegineta at the beginning of this chapter represent a thorough understanding of mental diseases often supposed not to exist at this time. Often it is presumed that this thorough appreciation of insanity gradually disappeared during subsequent centuries, and was not revived until almost our own time. It is quite easy, however, to illustrate by quotations from the second half of the Middle Ages a like sensible treatment of the subject of insanity by scientific and even popular writers. How different was the attitude of mind of the medieval people toward lunacy from that which is usually assumed as existing at that time may be gathered very readily from the paragraph in " Bartholomeus' Encyclopaedia " with regard to madness. I doubt whether in a brief discussion so much that is absolutely true could be better said in our time. Insanity, according to old Bartholomew, was due to some poison, autointoxication, or strong drink. The treatment is prevention of injury to themselves or others, quiet and peaceful retirement, music, and occupation of mind. The paragraph itself is worth while having near one, in order to show clearly the medieval attitude toward the insane of even ordinarily well-informed folk, for Bartholomew was the most read book of popular information during the Middle Ages.