BMJ 2012;344:e3881 doi: 10.1136/bmj.e3881 (Published 1 June 2012)
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Views & Reviews
VIEWS & REVIEWS MEDICAL CLASSICS
Raving and Melancholy Madness Mark Ellul foundation year 1 doctor, Peterborough City Hospital, Peterborough PE3 9GZ, UK Raving and Melancholy Madness Statues by Caius Gabriel Cibber First displayed 1676
These well known but grotesque figures supposedly represent the two faces of mental illness. One is reposed and quiet but vacant and disengaged; the other is full of anguish and writhing against the chains used to bind psychotic patients before the days of the chemical cosh. Raving and Melancholy Madness, sculpted by Caius Gabriel Cibber (1630-1700), stood above the entrance to the old Bethlem Hospital from 1676 until 1815 at its site in Moorfields, London. The representations are life sized and were designed to recline over a portico and look down on visitors and staff coming in and out. What possessed the sculptor to carve these caricatures to guard the entrance to Bedlam? Perhaps they were warning of what can happen when illness reveals the darker parts of the human mind. Possibly they were a descriptive work of art, in the same way as angels sometimes protrude from the walls of cathedrals, illustrating the purpose of the building they adorn. How many more statues would we need today, to depict the myriad conditions that fill the pages of the Diagnostic and Statistical Manual of Mental Disorders? Neurosis and psychosis no longer suffice to describe the many ways in which we can now be mad.
Unfortunately, it is more likely that they served as an advertisement. In the early days of the asylum, for a small amount of money (originally two old pennies), the people of London could walk the corridors and peer into the barred rooms where patients were chained. Frankly psychotic inmates were on display, and often subject to physical punishment as well as the humiliation of being shown in public. It is not clear what was achieved by making a freak show of mental illness: almost certainly the governors of the hospital were keen to display the public service they were doing by keeping the lunatics controlled, often in insanitary straw beds and naked. The visitors
seemed to have mixed motives in making their visits. Edward Moore, an influential journalist and dramatist, wrote in the World in 1772: To gratify the curiosity of a country friend, I accompanied him a few weeks ago to Bedlam . . . I saw some of the poor wretches provoked by the insults of this holiday mob into furies of rage; and I saw the poorer wretches, the spectators, in a loud laugh of triumph at the ravings they had occasioned . . . there is nothing so affecting as sights like these: nor can a better lesson be taught us in any part of the globe than in this school of misery. Raving and Melancholy Madness now reside in the museum of the modern Bethlem Royal Hospital in the quiet suburb of Beckenham in Kent. Like the hospital itself, they are physically removed from their original site and morally dislocated from their original intentions. Cibber’s statues are classics of hospital art, not only because of their disturbing, almost painful appearance, but also because they remind us how mental illness once appeared to the majority of the so called sane: something to be gawped at, laughed at, and almost definitely feared. Competing interests: the author has completed the ICMJE uniform disclosure form at http://www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declares: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years, no other relationships or activities that could appear to have influenced the submitted work. Provenance and peer review: Not commissioned; not externally peer reviewed. Cite this as: BMJ 2012;344:e3881 © BMJ Publishing Group Ltd 2012
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