Dan Snow's History Hit - How to Survive in Renaissance England

Episode Date: October 21, 2025

Quacks, wise women, barber surgeons and private madhouses - just some of the options available if you were to find yourself in ill health in the 16th and 17th centuries. Dan is joined by historian Dr Alanna Skuse to look at healthcare in Renaissance England, from healing the humours and blood letting to cross animal blood transfusions, skin grafts that involved attaching the face to the upper arm and the notorious treatments of patients at Bedlam, Britain's most famous psychiatric hospital. But not all treatments were bizarre or gruesome; in fact, early practitioners had some pretty progressive ideas around holistic health, the benefits of nature, sleep and friendship.Alanna shares astonishing stories of treatments, patients and practitioners from her new book 'The Surgeon, the Midwife and the Quack: How to Stay Alive in Renaissance England'Produced by Mariana Des Forges and edited by Dougal PatmoreWe'd love to hear your feedback - you can take part in our podcast survey here: https://insights.historyhit.com/history-hit-podcast-always-on.You can also email the podcast directly at [e-mail]. Hosted on Acast. See acast.com/privacy for more information.

We know you love the thought of a vacation to Europe, but this time, why not look a little further? To Dubai, a city that everyone talks about and has absolutely everything you could want from a vacation destination. From world-class hotels, record-breaking skyscrapers, and epic desert adventures, to museums that showcase the future, not just the past. Choose from 14 flights per week between Canada and Dubai.

Book on emirates.ca. Hello, it's Ray Winstone. I'm here to tell you about my podcast on BBC Radio 4, History's Toughest Heroes. I've got stories about the pioneers, the rebels, the outcasts who define tough. And that was the first time to anybody ever ran a car up that fast with no tires on. It almost feels like your eyeballs are going to come out of your head. Tough enough for you?

Subscribe to History's Toughest Heroes wherever you get your podcast. Hi folks, welcome to Dan Snow's History Hit. Now, if you were to take a train to History Hit HQ, well, you have to go to near a station. We don't have an actual station inside the building yet. You'd have to get off probably at Liverpool Street Station in the Middle of East London. That's not far from the River Thames.

Those of you who know this part of the city know it's a bustling hub of city workers in skyscrapers, plus us media types, tapping away in cafes, talking nonsense, offices in repurposed old warehouses. But what you might not know is that Liverpool Street Station sits on top of the site of the old Bethlehem Royal Hospital, which later became known as Bedlam, famed for its reputation as a mental asylum

that kept patients all too often in appalling, torturous conditions from the 14th century through to 19th, when thankfully underwent all sorts of reforms. It's one of the world's oldest psychiatric institutions, and it did mark a turning point in medicine and England, a transition from the world sort of holistic and folk, spiritual healing of perhaps faith healers, we call them, to more institutionalised healthcare.

But frankly, the stories that came out of Bedlam tell us that this wasn't necessarily a better route. So, as a person with ailing health in the Renaissance era, if you were suffering from a kidney problem, say, or from plague, or you were caught in the throes of depression, what were your options to get help? Would you go to a local wise woman, or the apothecary with its jars and drawers of remedies? Or would you enter the doors of an institution like Bedlam?

Well, in this episode, I'm going to go through all your options with the help of Dr. Alana Skews. She has studied the history of healthcare and Renaissance England and found some pretty extraordinary stories about patients and healers and the beginnings of the scientific revolution that was going to take place in England throughout the 16th and into the 17th century, well, and beyond. but how that revolution in health care didn't always deliver better results for the patients. It's a remarkable thought-provoking story, folks. Enjoy.

The T-minus 10. The Thomas bomb dropped on Hiroshima. God save the king. No black white unity till there is first than black unity. Never to go to war with one another again. And lift-off, and the shuttle has cleared the power. Alana, before we get started, the past has got a very bad reputation in terms of trying to be alive and pain free. Let's take the Tudor period, as it was in England. Would you time travel

back there or was it just unrelentingly grim for most people most of the time? In terms of your own irrespects what's going on around you, but your own health. Yeah, you would not catch me time travelling back to 16th century, all kinds of horrible diseases, sweating sickness, which we still don't really know what it was, infectious diseases all over the place, not to mention if you managed to have an accident, which a lot of people did, because obviously they're doing accident-prone-type things, doing lots of manual labour, working with livestock, working with horses all the time. So, yes, it's pretty grim.

What I would say is that there's an impression that it's almost purposely grim that the doctors and the surgeons and things are these sort of heartless sorebones who take delight in giving people disgusting medicines and chopping them up or they're still alive. Actually, most people most of the time are doing the best they can with the knowledge they have available to them. And they were sure they were doing the best they can, but often you read that medical intervention, it did more harm than good. I mean, were you often better off not going to a doctor? Yes, you're often better off not going to a doctor. From what I've it seems that probably your best bet is to go to a woman healer. So a lot of noble women

providing care for their servants and their family and their neighbours and also kind of middle class women doing the same on a smaller scale. They often are better because they're not using quite such potent ingredients. So they sometimes are using those ingredients like arsenic and mercury and so on, but not with such relish and sort of gay abandon as the physicians seem to be using them. Right. So it's the inherited sort of oral traditions, the ancestral, because as we know, there's so much that heals us in the natural world, they're using those more traditional remedies. Yeah, they're using things like Willow Bark, which is salicylic acid. It's a precursor to aspirin, but also things like rosemary and sage, a lot of the sort of cough and cold medicines have

you gargling with some mixture of those, and they are actually antibacterial. So they would have made you feel a little bit better. And some of the medicines that they take for pain, Things like Hellebore, Hembane, they're not good for you, but they would have had a kind of stupefying effect, which is why they were often given to people during acute illnesses or in preparation for surgery. They can also give you opium, which they know is a good pain medicine. They also know that it's addictive and they know that it can do harm. So that's why they don't tend to use it for surgery, but they are quite free with using opium for end of life care. So there are some things that they're doing, which are actually more effective than you would think. But the lads in London and Edinburgh are playing with new technologies and not knowing what the hell is going on and often making things worse for their patients. Right. Interesting. Yes. And there are a few particular examples of this. So in the 1660s, the Royal Society gets going and a couple of the members of the Royal Society decide that they will start experimenting with blood transfusions. And that sounds great. But the kind of transfusions they want to do, are not transfusions of human blood in people who've lost blood. That's very, very briefly suggested and seems to be immediately tossed out of the window. What they want to do is transfer blood between different species.

So they start with dogs and they go, well, if you put the blood of like a fierce dog into a timid dog, does it make the timid dog fierce? They do a number of experiments like this. And then they think, we've got a mad person here. let's put the blood of a sheep into him because a sheep is a nice tame animal and hopefully it will calm him down. They managed to do this a couple of times. Unfortunately, in France, some physicians are doing the same thing. They're putting the blood of a calf into a man and after a few rounds of this, unsurprisingly, he dies and then it gets banned and we don't have blood transfusion then for another 200 years. So if you happen to get on the wrong end of a physician's experiments, then

watch out. So frustrating because in a way those experiments are necessary for the birth of modern science and medicine, but there's a lot of collateral damage in the way. Okay, so if you want decent healing, go to a woman to deliver that. So true in so many fields. But I'm getting ahead of myself. Let's talk about what people thought, understood, whether they're healers or doctors or anyone, really, what they understood about, I mean, the humeral theory thing you hear about so often, aren't you, with the various humours? What's going with that? It comes from mostly Galen of Pergamon, is an ancient Greek, and it persists for an extraordinarily long time, mostly because it is actually quite intuitive. So you have your four humours. The four humours

travel around your body as fluids. It's a bit confusing because one of the humours is called blood, the sanguine humour, but they also all travel around. in the blood. There's a difference between blood humour and nutritive blood, which is the blood that you see when you cut yourself. And the four humours are on the spectrum of hot, cold, wet, dry. So you have black bile, which is melancholy, and that's cold and dry. Got yellow bile or choleric humour, and that's hot and dry. Flem, which is cold and wet, and blood, which is hot and wet. and those humours will affect how you look, how you act, the kind of foods that are good for you and the kind of illnesses you get. So they really are fundamental to everything about your

existence. Do you think that this was kind of quite widely a unifying thesis for really anyone involved in trying to work out why we were feeling good and bad? I think their understanding of the humours is a bit like our understanding now of cells. So you and I, and Joe blogs on the street, we all know that we're made of cells. We know that in a kind of abstract sense, but it doesn't actually affect my everyday life that much. It's just like kind of intellectual weather. The people over in the biology department of my university, they know a lot about cells and they're really interested in them and they are writing about that all the time. So yeah, they're looking at those cells every day. They're into them. Yeah, they love them.

And the thing about the humors is you can make that system as complicated. as you like. There's a lot of astrology and astronomy in the study of the humours, and you can go kind of down endless rabbit owls over, you know, which planet is influencing which humour at any given time. And too complicated for me to understand, and I've been studying it for a long time. Okay, so is there any usefulness in that that might have made anyone better ever? The usefulness to my way of thinking is the holisticness. nature of it, which I think is now coming back around to a certain extent. So in the system of the humours, you emphasise the impact of the environment on the person's health. So almost all

cures are what we would call social prescribing or lifestyle cures. Things like diet, things like seeing your friends, how your relationship is with your husband. Those are really, really important on a medical level. And it also means that there's no distinction. really between mental health and physical health, because the melancholy humours can cause you melancholia, like depression, the melancholy humours can also cause you cancer or migraines. And those two things aren't quantitatively different from each other. Okay, so in that respect, as an organising principle of looking at the human body, there is some utility there?

There is. And there's also specific things which we've actually picked up and used again. So we use leeches now again in hospitals. because they are quite a good way of getting infected blood out from the sites of wounds. There's a really mad operation that they use in the 16th century for replacing people's noses that have been lost from syphilis. It's called the Tagliocotian operation. Somebody called Gaspar Tagliococci in Italy is doing this. And then it disperses all through the continent.

And basically what you have to do, if your nose has fallen off because of syphilis, you get the person's arm. And if you imagine your upper arm, you cut three lines. So you cut three sides of a rectangle and then you fold that piece of skin back and you bandage it so it heals up. You leave that for a bit. And then you bandage the person's arm to their face and you have to leave their arm attached to their face for at least a month. They can't move. They're not really supposed to talk. They definitely can't sneeze. And the idea is that it grafts onto their face. And then you cut off the fourth edge and you can kind of shape it into the note. And this looks like one of the most bonkers things that you can do in Renaissance medicine. Even the other surgeons think that this is insane. But actually, it was used again in World War I. So some of these methods are more forward-thinking than you might imagine. Speaking of treatments, the idea you have to keep these humans in balance, right? So what are the ways you've mentioned using leeches?

How do they bring these humours back into some kind of equilibrium? Probably 80, 90% of all medicine at this time is really diet. Okay. They think that your diet is incredibly important and you're just redressing the imbalance of humours. So let's say you've got loads of choleric humours. They are hot and dry and they'll make you have hot diseases like fevers and things, what they call agues. There's a lot of what we would now identify as malaria.

So if they've got too much cholera in your body, you want to be eating things that are cold and wet. So lay off the hot dry things, which would be red meat, salted foods, cheese, red wine, basically all the stuff people like to eat. And you eat things instead like poultry, freshwater fish, lettuce and salads. And if you must have wine, then you have white wine instead. Well, I mean, some of that sounds like quite a good idea. Yeah, it's quite close to sort of heart-healthy diet now. Okay, so you've gone to the household healer.

they have given you actually some quite useful things because there's various, as you say, sage, rosemary, meadow sweet. There are things that do have an effect. So if we're a monarch and our lives are quite important, we're escalating, presumably. We're also getting self-appointed experts in. How else might we be treated? So if you're a monarch, you're probably going straight to the physicians.

You will be surrounded by physicians of various stripes. You will also have your personal surgeon. And depending on what's wrong with you, the physician or the surgeon might take the lead. Traditionally, physicians deal with everything that goes on inside the body. And a surgeon is brought in for anything that is to do with the outside of the body. So any kind of tumours, rashes, bleeding you, anything like that. And the physician or the surgeon will write you a prescription for a medicine. The surgeons aren't really meant to write prescriptions for medicine, but they all do it.

and then that will be taken to your local apothecary and the apothecary will make up the prescription rather like a modern pharmacist. In some ways, the monarchs are actually worse off because as I say, the physicians, you really don't want to let the king die. So they will go straight in with the strongest things that they can think of. And of course, we all know that kings like their red meat, their wine and all those other nice foods that the physicians thought they ought not to eat, it's rather difficult to tell them to lay off those when they can have your head chocked off. Right, exactly. And they've got fancy officers in London, whereas they're not going to the simple healing woman out in the villages in the countryside who's probably doing more good.

Yeah, the physicians are tremendously expensive, which is why there aren't that many of them. So between 1570 and 1590, I think there are 73 medical practitioners that we know of in Norwich, and only five of those are physicians. So they really are treating the lucky or unlucky few. They are like orders of magnitude more expensive even than a surgeon and certainly much, much more expensive than an apothecary or an itinerant healer, what we would now call a quag. Just talk to me quickly.

Why do people talk about barber surgeons? What is that elision there? So the barber surgeons are formed as a company in the early 16th century. Traditionally, barbers have been doing surgery because monks are not supposed to do surgery. Monks are doing the rest of the medical treatment, but they're not supposed to spill blood. And of course, a barber is pretty handy with a razor, so it makes sense. But over time, you have some barbers who are really just now doing surgery and not cutting anyone's hair, and some barbers who are still doing haircuts.

So they decide they're going to form this company of barber surgeons so that they can keep tabs on everybody. and the surgeons agree, they're going to stop trying to cut people's hair, they're just going to do medicine, and the barbers agree, okay, they're not going to do the medicine anymore. It's not until the 1740s that that divide gets broken down even more, and you have a college of surgeons, which is why now we call surgeons mister rather than doctor. It's because initially the college of surgeons were very precious about their title of doctor and they didn't want anyone else using it. So quickly before I come on to the mental, I think I was to ask because you mentioned it. Bloodletting, we've touched it briefly. That seems a big feature. Why were they so obsessed with getting blood out of the body? They really were obsessed with it. And it's not that physicians really want to do it that much. It's the basic part of the physician's repertoire. But it's driven actually by patient demand. A lot of patients are saying, I will be let blood twice a year, whether I need it or not. It's a bit like going to the dentist. And the theory is, is that if you've got too much black bile in your nutritive blood, the blood that's going all around your body, then obviously if you let some of the blood out, then a greater proportion of the black bile is going to come out than it is of the other humours. So it does kind of

make sense. Now, whether this ever helped anybody is a matter for debate. On the basic level, it probably mostly did harm. It certainly would have made people a bit doping. So maybe it will have enabled them to sleep sometimes. But for some conditions that stem from high blood pressure, it might actually have provided some temporary relief. And there are a few modern scientific papers looking into that. So through the 16th century, do things start to improve? Like, what's the point at which you would be confident to go to one of these physicians or doctors or medics?

My thinking is around about 1985. But what would you say? I mean, we talked about the barber surgeons. organize themselves. Are there things that start going on through the 16th century that point towards the present? There's increasing attempts to formalise and organize all kinds of medical practitioners for better and worse. So as soon as you have the College of Physicians who are established in 1518, other bodies start to realize that they need to organize themselves, otherwise the physicians are going to take over. So it's first the surgeons and then the

apothecaries. And then in the 17th century, the physicians and the surgeons are relentlessly trying to organise the London midwives. Never actually works because the midwives don't want to be organised and especially don't want to be organised by the surgeons who are endlessly seeking to boss them around. You listen to Dan Snow's history. Don't go anywhere. There's more to come. We know you love the thought of a vacation to Europe, but this time, why not look a little further? To Dubai, a city that everyone talks about and has absolutely everything you could want from a vacation destination.

From world-class hotels, record-breaking skyscrapers, and epic desert adventures, to museums that showcase the future, not just the past. Choose from 14 flights per week between Canada and Dubai, Book on emirates.ca today. I'm Professor Susanna Lipscomb, and on not just the Tudors from History Hit, we do admittedly cover quite a lot of Tudors,

from the rise of Henry the 7th to the death of Henry VIII, from Amberlin to her daughter, Elizabeth I. But we also do lots that's not Tudors, murderers, mistresses, mistresses, pirates, and witches. Clues in the title, really. So follow, not just the Tudors from History Hit, wherever you get your podcasts. So things become more professionalised, but does that mean a higher standard of care

or moving towards more sophisticated methods of treating people? The one thing that can happen once you have formal bodies is that you can bring people to account. So the College of Physicians will quite frequently bring people in for discipline. if they think that they have committed malpractice. And you can bring a suit against a physician if you think that they've done the wrong thing. So there's a Dutch physician called Johannes Grosnabelt. And he's brought to court in the 17th century because they say that he's given an unhealthy amount of something called Spanish fly, which is a kind of toxic caustic beetle to this woman who is pregnant.

And then she finds that she can't walk anymore, which is obviously pretty serious. So there is some recourse. It keeps a lid on the excesses of physicians because they're aware that they can be brought to book for their actions. And so does that lead to an improvement or at least I suppose it leads to your ability to identify and get rid of the worst offenders, terrible malpractice, which probably does lift the overall standard? Yeah, it's difficult because occasionally the worst offenders are actually the people who run the College of Physicians. So there's a guy operating in St. Barts and The apothecaries say that he has been prescribing ridiculous doses of this toxic medicine.

But of course, because he is the head of the governing body, you can't really do anything about it. I wouldn't say it makes a load of difference to standards overall. Really, the driving factor, if standards go up, is not the trade bodies. It's the customers. These are service providers. and if you get a reputation for not delivering or for delivering but in a way that's really horrible or always prescribing things that are really unpleasant, people just won't go to you. Well, that's a rugged capitalist approach, I suppose. That works. Okay, so now what about hospitals

because we start to see some big hospitals that still survive in Britain to this day and trace their lineage back to this sort of early modern period. And are those hospitals already differentiating sort of mental health to physical health? Or is it, Are they still just a catch-all? Pretty much the only hospital for the mentally ill in this period is what was originally called the Priory of St. Mary of Bethlehem, which we would now know is Bethlehem or Bedlam. The other hospitals are pretty much exclusively for physical illness. Now, how often a degree of mental illness is going along with the physical illness is up for debate, especially as the hospitals really expand during the Civil War. So obviously you've got people in there who've got physical injuries, but also experienced a large amount of trauma, both mental and physical.

Okay, so I imagine just simply living in this period with the amount of infant mortality that you'd have been through as a parent, the amount of physical pain you'd been. I imagine your mental health would not be in terrific state most of the time. No, it's difficult to say. There was, for a long time, among historians, a sort of feeling that because people lost children, often. So one in 10 children die before their first birthday, one in four dies before they reach adulthood. Because it was so common, parents were kind of deadened to it. They didn't expect their children to live. Actually, if you read the accounts, parents react as you would think that they might react, as a modern parent would react. They experience that grief every time.

So it's an incredibly difficult time to be a woman in particular, I think. Yeah, I agree. I find those sources so interesting when you get a glimpse into the horror, the pain that they went through, which feels like our own would be. And then you think, God, all of them were going through that a lot and through their lives. So let's keep talking about the mental health and Bethlehem Hospital in particular. Was it treated in the same way, humours, it's a humoristic treatment, or did they start to develop different approaches when it seemed to be just the, perhaps just the head that was wounded rather than obviously the body?

Mental health has an interesting division between hospital and everywhere else. So in Bethlehem, the main treatment seems to have been bleeding people. It was very much humours-based treatment. You bleed them, you purge them and you give them things to make them vomit. And that's pretty much all that they could do for people. out in the community, you have treatments that look a lot more like what we would understand as holistic treatments. So in Robert Burton's anatomy of melancholy, was published in 1621, he suggests, can you get the person to go outdoors, can you make them take some exercise in the

fresh air, can you make sure they see their friends, make sure they're not drinking too much and they have a good diet? So those are more holistic, more humane treatments, but the ones in Bethlehem are pretty bad. Okay, but again, interestingly, it sounds like those are, well, I don't want to say common sense, but it sounds like those are not super advanced methods of treating mental health. They are just doing the basics. Yeah, but I think the basics quite often work, because when we see the private madhouses, in the 17th century, partly because Bedlam is so awful, you start to get private asylums, which will take in the mentally ill. And they report quite good success rates. We have to take that with a pinch of salt, but a lot of them are advertising

themselves, are saying, okay, so-and-so's wife was completely distracted, but we cured her in three weeks and she went home. And I wonder in those cases, if actually what's happening is they're taking the mentally ill person out of the environment that has made them ill, maybe out of kind of an abusive domestic situation or something. And so what they're really offering is a kind of hospice, which is probably the thing. the people need most. Where it's clean and their trauma can be sort of engaged with and it's just a safe nature surrounded environment, I suppose. In theory, yes. I mean, the private madhouses vary a lot in their quality, but they advertise themselves as being warm. They specify that they have good fires in

every room, having good meals three times a day and yet having a lot of access to nature. in some of them there are patients who are there for a long time and those are obviously the people who are more seriously mentally ill or possibly people with learning disabilities who are being misdiagnosed was there a stigma around mental health somehow people treated differently to people with more obviously physical ailments they are equal opportunities horrible to everyone I would say so you do get incidents of people mocking

and being cruel to people with mental illness. And you certainly get those visitors to Bedlam, right? It's quite a popular destination for apprentices to take their dates. And they go and they kind of poke at the people in Bedlam through the bars and try and make them lose their temper and tease them in various ways. We can name some of these characters. I mean, the leadership was woeful, if we can call it that. I mean, it seemed to be just an opportunity to, well, for corruption.

Tell me about, is it Helquier crook? There's a bit of a nomadic determinism here. Yeah, crook by name and crook by nature. Crook is the exception to what I said earlier about most people are trying their best most of the time. Crook takes over in 1618. He's had his eye on Bedlam for a while. And he basically runs a smear campaign against the previous keeper at Bedlam. He takes over whether he has good intentions when he takes over or not.

I don't know. But pretty soon he's barely there. There's no obligation for the physician that attends Bedlam to be there a set number of days a week. So you can choose your own. And what he chooses is none. Instead, he leaves it to his son-in-law to do all of the day-to-day work. He's also siphoning off money. So by 1633, there's an investigation taking place. And it reveals that for each patient admitted, this is a charity, so it's meant to be free. but Crook has been charging between 15 and 20 shillings and just pocketing that money. He's also been selling off land that belongs to the hospital. And at one point, he's even sold some of the beds.

So he's embezzling around £100 a year, which is not an insubstantial amount of money, straight into his own pocket. Eventually, it's the embezzlement that gets him kicked off the job rather than the cruelty to patients. Even though there's been inspections where they've seen that the patients are effectively starving, it's freezing cold, there's open sewers running basically through the hospital, so it's absolutely filthy, and the patients routinely have nothing to eat. You listen to Dan Snow's history at there's more coming up. We know you love. the thought of a vacation to Europe. But this time, why not look a little further?

To Dubai, a city that everyone talks about and has absolutely everything you could want from a vacation destination. From world-class hotels, record-breaking skyscrapers, and epic desert adventures, to museums that showcase the future, not just the past. Choose from 14 flights per week between Canada and Dubai. Book on emirates.ca. today.

I'm Professor Susanna Lipscomb, and on not just the Tudors from History Hit, we do admittedly cover quite a lot of Tudors, from the rise of Henry the 7th to the death of Henry the 8th, from Amberlyn to her daughter, Elizabeth I. But we also do lots that's not Tudors, murderers, mistresses, pirates and witches. Clues in the title, really. So follow not just the Tudors from History Hit, wherever you get your podcasts. I made a program once on what people called shell structure in the First World War

and I was very struck with how PTSD presents differently in different generations because they have different cultural and social contexts. Do we know whether, if you went to Bethlehem Hospital, how did people present with mental health problems back then? I mean, are there descriptions of those symptoms? of what that building was like? So when Bedlam moves to a slightly newer site in the 1670s, there are two statues at the front of it.

One of them represents melancholy and the other one represents frenzy. And those are basically the two ways in which madness is understood. Either you're kind of depressive, you don't have any engagement with the world, or you're frenzied, you're violent, you're hyperactive. And whether it relates to PTSD is quite an interesting. idea. There's a lot of what we call religious melancholy, and I wonder if that is to do

with the presence of death. Death is very close at hand, especially during wartime, and people become very, very occupied with the idea that maybe they are going to hell, maybe they're not capable of being saved, that can manifest in these depressive symptoms. It can also manifest in delusions. So something that a lot of writers at the time talk about is people who, who believe they're made of glass, people who believe they are birds or swans or something like that. And sometimes they try and trick them out of it. So there's a story in, I think, Robert Burton's book about a man who is afraid to urinate because he thinks that his bladder somehow holds gargantuan amounts and he will drown everybody else. And so to fix this, they stage a small

fire. And they tell him that the town is on fire and he needs to urinate on the fire to save the town. And apparently this works. Amazing. Well, that's extraordinary. So there's through the 17th, 18th century, lots of use of restraint that people can pay to go and laugh at them. I mean, it sounds horrific. The Enlightenment principles don't seem to be touching the mentally ill in London yet. No. So after Crook's tenure, a few years later, somebody called Tom. as Alan takes over Bedlam. And he doesn't really have any better options for treatment, but we think that he has at least better control over the staff, which has always been a problem. It's endless writing among the Governor's Board of Bedlam about, well, we need to tell them to stop

hitting the patients and stop stealing things from them. In Alan's tenure, we know that the patients are getting stuff brought to them by their friends and family, and they are managing to keep hold of that. So that's something. But James Monroe is elected as the keeper of Bedlam in 1728. And it then stays in the Monroe family for about 125 years. There's four generations. And the Monrose not only stick with the old treatments, but stick with them when there are known to be better alternatives. They just have no interest in keeping up with developments in mental health care. Bedlam only really starts to get better in 1852 when William Hood comes in and he institutes something called the moral cure, which is not moralising two patients, but rather putting

a great deal of emphasis on routine and occupation. So you have things like they'll have a ball every couple of weeks in the 19th century. They have gardens where they can work. The women are doing sewing and things like that. So that's really the turning point, even though. no, it's far from perfect. In the early 19th century, when these things are starting to happen across British society, there's an interesting, a parliamentary inquiry into Bethlehem hospitals undertaken, and they discover all sorts of horrific things. Is that what drives a move to a new facility,

it's trying to create better spaces? Yeah, so there's always been this belief, which is now borne out by clinical evidence, that being outdoors, being in nature, is one of the best things you can do for people's mental health. And so Bethlehem has continually moved further and further out from London, and it's basically been in pursuit of that green space. So in the site where it is now, it's still got actually quite a bit of green space, but that was initially right out in the rural surrounds of London and has now been built up around, and I dare say at some point it will move again. The site where it is now is also they built it specifically so that none of the buildings

are more than one story high. And that's to make it less like an institution to use the kind of negative phrase and more like a sort of home from home. There's so many therapeutic interventions you can make that do not involve, well, drugs, equipment, all that kind of thing. Yeah, that's true. And some of what we do as I'm a literary scholar and a historian is do work with people with mental health difficulties that involves creative practice. So last year I ran a project where we did a theatre production with some people who'd experienced mental ill health. And over six months, we kind of talked about these historical cases. And they created an amazing production from that. And it was both a way to talk about it without talking about it, right? So you can

talk about Julia Caesar's Portia who cuts her leg without talking about your own. own self-injury. It's a way in that's destigmatised. And it's also something you do with other people, you achieve something at the end, and there's not the pressure of the traditional ways of achieving things, which would be school, jobs, those kinds of environments. So there are lessons there that we can use, I think, probably more widely in mental health. So this is what's so interesting about your work is there are real lessons. I mean, I think all history's got lessons, including sort of discussions of Habsburg Castle Building, a century up in the 16th century,

but with yours, there's so many obvious things that stimulate thought about the world that we live in today and the arguments about healthcare and mental health and physical health and all that kind of thing. As you're doing this work, what are some of your big lessons that you draw out and think it might be useful for us all to know about as we can debate healthcare? Yeah, that's interesting. The thing I'm very interested in at the moment is the idea of proof and evidence. And I'm really curious about, where evidence-based medicine starts to be used and how we decide which medicine is proven and

which isn't. There's this fascinating guy in the 1660s. He comes over from Ireland in 1665 and his name is Valentine Great Rakes, but they call him the stroker. And that's because, say you have a headache, he'll stroke little strokes from your head down to your fingertips or your mouth and he'll stroke the headache out of your body. Now, Great Rakes, he's brought over to cure Lady Anne Conway, who suffers with these terrible migraines, but it doesn't work. But he cures lots of other people, and he becomes really, really popular. He's actually summoned to Whitehall for Charles II to see his stroking. That doesn't work either. But he goes into London, and he's in the parks, he's in St. James's park, absolutely thronged with would-be stroke-ease.

It's so crowded that one woman can't get near enough to be stroked, so she buys what she says is a jar of his urine and pours it into her ears. So in some ways, Great Rakes is the quintessential quack. He has all the hallmarks of a quag. But he's going home and the same week is writing to Robert Boyle is in correspondence with members of the Royal Society. And they are saying, well, actually, we think there's something in this. We just don't really understand quite how it works. So he's right on that cost between alternative medicine, quackery, and mainstream medicine. And for me, that's a source of curiosity. I don't know if I've learned from it, but it certainly makes me want to investigate more where our ideas of what is and isn't

legitimate medicine come from. And I guess you've thought a lot about regulation and ensuring that these places we're protecting the rights of those who are ill in these institutions. Yes. In St. Bart's Hospital, there's, I think it's John Woodall, he's the surgeon there, and he writes in one of his books that he's seen this experiment described somewhere where amputees are given reeds as prosthesis. I think he's describing maybe bamboo, but he says they attach great reeds to them as prosthesis. And then he says, but, you know, I couldn't find anyone who wanted to have that done, so I had to let it go. And he describes this as really, to his credit,

that he's not experimented on people against their will. I mean, one of the good things that Thomas Allen does when he's the keeper of Bedlam is when the blood transfusionists come and they say, we want a mad person so we can do our transfusing a sheep's blood into them, he says, no, no, you're not taking one of these people out of the hospital so you can do experiments on them. So there is some good in them. Well, I'm glad to hear there's some good in them.

Alana, thank you so much for coming to the podcast. Tell everyone what your book is called. It's called The Surgeon, the Midwife, the Quack, How to Stay Alive in Renaissance England. It's useful, folks. Very useful. Stay alive. Thank you very much for coming on the podcast. Thank you. Thanks for listening, folks.

I've got some big news. We're changing to a new release schedule in November with new episodes dropping on Mondays and Thursday. Bonus episodes are on Friday. If you're a subscriber, which he should be by now. We're going to change things up because we want to, well, deliver the best podcast we can, make sure you get the best of us.

So fewer episodes, but we're going to do deeper dyes, going to do more of those explainers, more on location adventures, more focus on the history you love. Look, if we're doing fewer episodes, we can make sure they're higher quality. That's the laws of physics, folks. And also because we're getting lots of stuff across history in general. We've got the YouTube channel, which I hope you subscribe to. Well, I've got a couple of YouTube channels now.

The TV channel, and we're also making some old-school TV, well for National Geographic and Channel 5 in the UK. So we're all embarked on some pretty big adventures. Mariana DeForge, the producer, has upped her shoe game. She is ready. I'm ready. I can't say too much now, but she's going to need those shoes. That's what I'm saying. We're going to be traversing the Great Wall of China. We're going to be following in Napoleon's footsteps across chunks of Europe. And if I get my way, if I get my way, and I'm better, we're going to be tracing the story of the Odyssey from Troy to Ithaca, which actually, if you think about it, is the ultimate historical adventure.

That's it. You told me that when I was a kid that I'd be doing that in my slightly advanced years. Well, I'd have been happy. That's as good as you get. That's winning the World Cup of history. So worry not, folks, the podcast isn't changing. It's just getting even better. We know you love the thought of a vacation to Europe.

But this time, why not love? look a little further to Dubai, a city that everyone talks about and has absolutely everything you could want from a vacation destination, from world-class hotels, record-breaking skyscrapers, and epic desert adventures, to museums that showcase the future, not just the past. Choose from 14 flights per week between Canada and Dubai. Book on emirates.ca. Today. Hello, it's Ray Winston. I'm here to tell you about my podcast on BBC Radio for history's toughest heroes i've got stories about the pioneers the rebels the outcasts who define tough and that was the first time anybody ever ran a car up that fast with no tires on it almost

feels like your eyeballs are going to come out of your head tough enough for you subscribe to history's toughest heroes wherever you get your podcast