Whereas The History of the Bethlem Hospital ^{Reference Andrews, Briggs, Porter, Tucker and Waddington1} , though excellent, is both expensive and difficult to procure, we have here two accessible books on a similar theme, with the more lurid term ‘Bedlam’ used as the key attention attractor.

Catherine Arnold, having previously written about London's Victorian cemeteries in Necropolis, ^{Reference Arnold2} has an ear for a good story. She starts in the 13th century with Simon Fitzmary, who, possibly inspired by an angel whispering in his ear but also somewhat of a political operator, gave over land north of St Botolph's at Bishopsgate, where Liverpool Street Station is now, for the foundation of a charitable priory dedicated to the Virgin Mary of Bethlehem (hence ‘Bethlem’ and its derivative ‘Bedlam’). The monks soon fell on hard times, however, and by the next century had to appeal to the mayor for funds. The focus on the mad arose in the 1370s when King Richard II ordered the priory to take in the lunatics, then being looked after at Stone House near Charing Cross, as he considered them to be too near his palace. An early institutional scandal was the next event, with Peter the Porter, who had essentially run the place, being found to have taken all funds and goods supplied for his own use and charged the patients for their food and fuel. The following century showed no improvement, as the church's appurtenances were sold off and the churchyard used for market stalls. Reforming masters then took over, including a Thomas Maudesley who became a warden in 1485.

In the 16th century, all hospitals connected with ecclesiastical establishments stood in peril. The Bethlem escaped, using connections both with the sovereign and the City of London to survive, but linked in management with the Bridewell prison. Stories of abuse and neglect continued, only temporarily interrupted from time to time, as when King James took a special interest and arranged the appointment of a new medical manager Helkiah Crooke, who unfortunately began later to live up (or down) to his name. After the fire of London more good intentions led to the erection of a new and palatial building, which however in its turn became famous not only as a tourist site to see the lunatics but as a pick-up joint. In the 1800s, when the building was collapsing and a commission of inquiry showed appalling conditions, King George III's own madness reminded the country that the mentally ill deserved better care. The result was the rebuilding of the Bethlem in Kennington, where the central block remains as the Imperial War Museum.

While Arnold's text scampers on, not very satisfactorily, into the 20th century, Paul Chambers dwells with greater detail on the doctors of the 17th and 18th century in charge of the Bethlem, who seem less notable for their academic ability than for making a good living and ensuring nepotistic successions. Description of the rival hospital, St Luke's, is of particular interest. Under the charge of Dr William Battie it contrasted in plainness of design, in admitting solely by charity, abjuring the use of ‘violent medicines’ and in openness to formal inspection.

Both books are entertaining and extend into different areas, although forays into the wider concepts of madness are variable in quality. For those who want to find the source of an especially good story, the Chambers is preferable as it has a greater use of well-referenced primary sources and a good bibliography, as well as some useful illustrations.