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Art and Images in Psychiatry
April 2003

A Rake's Progress: "Bedlam"

Author Affiliations

James C.HarrisMD

Arch Gen Psychiatry. 2003;60(4):338-339. doi:10.1001/archpsyc.60.4.338

WILLIAM HOGARTH (1697-1764) was an English painter and engraver, humorist and satirist whose best-known works include several series of popular satiric engravings in which he ridiculed the viciousness and folly that he saw in the world around him.1 Hogarth was born in London, England, on November 10, 1697. At an early age, he showed artistic talent and was apprenticed to a silver engraver in London. Hogarth's fame began in 1731 with a series of 6 pictures called A Harlot's Progress, the first of his "modern moral subjects" (a progress being a journey toward a goal). Other series followed, including A Rake's Progress (1735) and Marriage a la Mode (1745). Editions of these engravings sold well. Hogarth played a major role in legislation leading to the artists' copyright law, often referred to as the Hogarth Act; he delayed the publication of A Rake's Progress until its passage. Hogarth responded to humanity as a whole, satirizing its weaknesses, pretensions, and vices. He is respected for his originality, his superb rendering of costume and setting, the accuracy of his vision, his humor, and the humanness of his characters.

A Rake's Progress is a series of 8 paintings and engraved prints that follow a young man, Tom Rakewell, who has inherited a fortune from his miserly father and naively presumes to be a man of fashion. He abandons his pregnant girlfriend, Sarah Young, and squanders his inheritance drinking and gambling, despite her pleas. Eventually he is confined to a debtor's jail and finally to the Bethlem hospital for the mentally ill, commonly known as Bedlam.

Hogarth's "Bedlam," the final scene from A Rake's Progress, is the closest to an authentic picture that exists of the interior of the Bethlem hospital before the 19th century. It was located just outside the city walls of London in Moorfields. The building was designed by Robert Hooke, and 2 reclining statues by Caius Gabriel Cibber—one in chains portraying Raving Madness and the other portraying Melancholy Madness—framed its entrance. Features of the painting suggest that this is the interior of the main hospital. On each side of the main floors were galleries 16 ft wide that ran the full length of the building. Iron grills in the central area separated the men's wing from the women's wing. Individually numbered cells that measured approximately 12 ft by 8 ft opened off the galleries. The galleries were day rooms for those who could safely walk about; violent patients remained locked in their rooms during the day. The galleries became notorious because although some visitors were legitimate, others were sightseers who came to watch the patients for edification or even amusement, a practice that was stopped in 1770. In 1753, a journal correspondent visited during Easter week and wrote, "[T]o my great surprize, I found a hundred people at least, who having paid their two-pence a piece, were suffered unattended to run rioting up and down the wards, making sport and diversion of the miserable inhabitants.. . ."2(p9) Two such female visitors are shown in Hogarth's painting. Although the paintings were completed before the engraved prints were prepared and exhibited, they were not sold. The engraved prints were accompanied by a poetic caption ("Madness, Thou Chaos of Ye Brain") by John Hoadly and were modified several times. The last changes to the engraved print reproduced in this article were made in 1763, the year before Hogarth's death. He changed the posture of Rakewell and shows the woman with the fan turning her head away. Hogarth added a 1763 halfpenny to the wall between cells 54 and 55 in the engraving that is inscribed "Britannia"; he depicts her with wildly flying hair, suggesting that Britannia herself has gone mad.3

Four figures form a pyramid in the foreground of the painting and on the viewer's left in the engraved plate, in which the image is reversed. Rakewell is shown in shackles and nearly naked, his posture echoing the Cibber statue of Raving Madness.3 Regardless of the suffering he has caused her, a tearful Sarah Young kneels beside him, remaining faithful to the end and now looking on distraught at his final reckoning. Beside her is a cauldron, possibly of milk pottage, which was provided on nonmeat days to feed those admitted to Bedlam. A male keeper or "basketman," as they were known, is either applying shackles to restrict Rakewell's movements or freeing him from his chains as he nears death. Thomas Bakewell, who was allowed by Hogarth to make and sell a set of inexpensive prints, commented on Rakewell: "Having attempted to lay violent hands on himself, they are obliged to chain him. He is afterwards confin'd to his Bed in a dark room, where he miserably expires."3(p28) The standing figure in the painting might be the physician, apothecary, or steward; however, the clerical bands in the engraving suggest that he may be a cleric—summoned because Tom is near death. The pyramid resembles the composition of a Lamentation of the Dead Christ (Pietà), with Sarah in the position of the bereaved Virgin Mary. If this was intended by Hogarth, the use of this configuration for Tom's "progress" is the antithesis of the spiritual development described by John Bunyan in his Pilgrim's Progress. In Bunyan's spiritual autobiography, one proceeds in the world surrounded by alternative self-images. Bunyan aspires to the role of Christ but fears that he has assumed the role of Judas, Peter, or Essau.1 In contrast, Hogarth shows his protagonist losing himself in his theatrical roles and among psychiatric patients with delusional identities. Hogarth's "progress" closes off self-awareness as he mimics and imitates various roles. Tom may be an innocent, but he apparently does not enjoy his various exploits in Hogarth's modern moral tale. Ultimately he is a victim playing a role; it is a fatal pretense with his demise the consequence of unreflected self-indulgence.

Cell 54, marked above the door, houses a man with a religious delusion who looks toward a cross as light streams through the window. His wooden bed is covered with straw and there is a bowl next to it, similar to the traditional depiction of religious hermits. On the wall are religious medallions of Catholic saints whom Hogarth felt represented fanatical beliefs: St Clement, St Athanasius, and St Lawrence. In cell 55 a naked man, apparently believing that he is a king, wears a crown of straw and holds up a stick as a scepter. He is urinating, to the amusement of a fashionably dressed lady who peers from behind her fan while her maid whispers in her ear. Their behavior is in striking contrast to Sarah's continued compassion for Tom despite his betrayal. Near the door of cell 55, another man has drawn a picture of a ship with the earth and its meridians and arcs—showing the North Pole at one end, a crescent moon, and various geometric patterns—in an attempt to discover a means of calculating longitude at sea, apparently by firing bombs.

A man peers through rolled paper as though looking through a telescope to see the stars. Another man in the center, believing that he is a tailor (tailors proverbially went mad with pride) and wearing a patterned hat with straw in his hair,4 frantically twists a tape measure in his hands, perhaps preparing to measure Tom for his shroud. Finally on the right, a musician fiddles away with the musical score forming a hat to cover his head. A manic patient next to him pontificates, perhaps deluded and believing that he is the Pope. He holds the papal cross, identified as a Latin cross with 3 unequal crossbars, and wears a tall paper hat decorated with more crosses. In front of him sits a man with a melancholy expression, unresponsive to a dog barking at him. He is said to be deranged as a result of his unrequited love for a prostitute whose picture he wears around his neck. Inscribed on the stair rail in the engraving is her name: Charming Betty Careless. This figure provides a metaphor for this moral tale. Tom became infatuated with a lifestyle that did not suit him, sought to take on aristocratic bearings, squandered his fortune, and betrayed his lover. Such pretense led to his ruin and ultimately to his death.

Since Hogarth's time, the story of A Rake's Progress has remained popular. In the 20th century it was the subject of an opera, The Rake's Progress, by Igor Stravinsky that addresses man's immaturity and how the failure to establish an inner life results in self-destruction.5 Thus, it is the enduring story of the futility of not developing an inner life and the consequences of constantly and disingenuously playing a role but never one's own.

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