This article was first published in the October 2012 issue of BBC History Magazine
From the small centres of religious care founded in the medieval period to the growth of asylums in the 19th century, the way that society has treated its disabled communities has changed greatly since the Middle Ages. However, the subject has seldom received the scrutiny it deserves.


“With this in mind,” says disability historian Simon Jarrett, “English Heritage has tracked the influence of disabled communities on the historic built environment – from the medieval period to the late 20th century – finding out how people with disabilities were seen, and how they saw themselves.”

Disability in the medieval period was viewed in two distinct, and rather contradictory, ways. On the one hand a mental or physical impairment could be viewed as a punishment from God; on the other, those disabilities were sometimes seen to actually bring sufferers closer to God.

“To be charitable to those with a disability in the medieval period was thought to speed a person’s journey into heaven after death,” says Jarrett. “It was not uncommon to find particularly pious people washing or kissing the feet of lepers, or endowing leper hospitals. Henry II himself visited a leper hospital in Canterbury to atone for his sins following the murder of Thomas Becket in 1170.

“People with learning disabilities were usually cared for within their families and communities, and almshouses could sometimes be accessed for those without such help. And, as ‘deserving poor’, many physically disabled people were granted begging licences to enable them to earn money.”

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But where the medieval period is notable for the religious orders that provided care for disabled people, the dissolution of the monasteries under Henry VIII saw many physically and mentally impaired people lose their sole means of survival.

“The Tudor period heralded a move towards a more secular type of support for disabled people,” says Jarrett, “and some of the religious hospitals that had been closed during the Reformation were re-founded by boards of governors, with charitable contributions.”

Those with a disability were not always confined to a life of poverty or secular care, though, and some were welcomed into elite circles. Research by historian Suzannah Lipscomb has even revealed that ‘fools’ employed to amuse the Tudor court may have in fact had learning disabilities.

“There were deemed to be two types of ‘fool’ during the Tudor period,” says Jarrett, “‘natural fools’ (referring to those with a learning disability), and ‘artificial fools’ (those who acted the part). Will Somer, Henry VIII’s ‘fool’, had his own apartments at court and was finely dressed, yet was deemed unable to look after himself and had a paid carer. This, Lipscomb believes, indicates that he may have been what was then known as a ‘natural fool’.”

Warfare has always promoted advances in the care of wounded or disabled people and the aftermath of the Elizabethan wars of the late 16th century saw the development of pensions and other types of practical, non-religious support for returning soldiers. The move from a religious to a secular view of disability continued through the 17th and 18th centuries, as large military hospitals such as the Chelsea Hospital for disabled and infirm soldiers and Greenwich Hospital for disabled and infirm sailors became more commonplace. The treatment of mentally ill people also went through substantial changes during this period, as private ‘madhouses’ grew up around Britain, where wealthy patients could stay until they ‘recovered their reason’.

The 18th century also saw the introduction of the first deaf and blind schools, and the beginnings of what we now know as British Sign Language. The first school for the blind was opened in Liverpool by Edward Rushton, himself blind through disease, in 1791, and attempted to equip those with visual impairments with skills to enable them to support themselves.

Things changed again in the 19th century – the heyday of the asylum system, when people turned to institutional solutions to mental and physical disabilities rather than the community and familial care of the past. “The Victorian idea that those with a mental illness were somehow dangerous meant that many were confined to lunatic asylums,” says Jarrett.

Subsumed into lunacy legislation were those with lifelong learning disabilities who failed to respond to treatment. Many remained in asylums indefinitely.

The treatment of disabilities improved rapidly in the 20th century, especially in the wake of the two world wars. Two million servicemen returned from the First World War disabled and unable to resume their former lives. Rehabilitation – as well as medicine – would prove key to their treatment.

The Second World War saw huge leaps in surgery, as well as prosthetics and plastic surgery. It also precipitated the development of a disabled rights movement, which saw blind ex-servicemen protesting about pensions and levels of support in the early 1950s.

“The English Heritage project aims to dispel some of the myths surrounding disability history,” says Jarrett, “but also highlights how attitudes have changed since the medieval period. Disability history is often dominated by the asylum period of the 1840s–1980s, but the story is so much bigger than that.”

Eight places associated with the history of disability


St Mary Magdalen Chapel, Ripon, North Yorkshire

Where outcast lepers could seek food and shelter

Leprosy, a disease that can inflict severe deformity on sufferers, has been much feared throughout history. Although often believed to be a divine punishment from God, the obvious suffering accompanying the condition (now known as Hansen’s Disease) led some to believe lepers were in fact closer to God than most and should be cared for as such.

Medieval religious institutions ran leper hospitals that cared for sufferers in both the spiritual and physical sense. They provided a good diet and clean environment, as well as a chapel for patients. ‘Tame lepers’, as those residing in leper hospitals were known, were sometimes admitted as brethren or as sisters.

Unusually, both the leper hospital and chapel at Ripon were open to ‘wild lepers’– as the afflicted living outside of such institutions were known – and those born in the Ripon area were provided with a daily food ration and clean clothes.

Founded in the 12th century, the hospital chapel of St Mary Magdalen is all that remains of the leper hospital, and is open to visitors.


Imperial War Museum, London

Where Britain’s first mental illness institution opened its doors to the criminally insane

Bethlem Royal Hospital (often known as Bedlam) is one of the world’s oldest hospitals for the treatment of mental illness. It was founded in 1247 as the priory of St Mary of Bethlehem, the site now covered by Liverpool Street station.

During the medieval period, the hospital was home to just 20 people, and while the violent and dangerous were restrained with manacles and chains, this was thought to assist the return of sanity. Following the dissolution of the monasteries in the 16th century, Bethlem was (along with four other ‘royal’ hospitals) handed over to the corporation of the City of London, which raised funds to run it.

Increased numbers and crumbling structures saw a new baroque building open at Moorfields in 1676, and in 1815 the hospital moved to St George’s Fields, Southwark, part of which still survives as the Imperial War Museum. This latter building had a special wing for criminal lunatics, which saw, for the first time, specialist provision for mentally ill people who had committed crimes.

Bethlem Royal Hospital has now moved to Bromley, south London, where it continues to provide services to mentally ill people.


Hampton Court Palace, East Molesey, Surrey

Where Tudor ‘fools’ enjoyed royal favour

Paid to amuse their royal employers, ‘fools’ were highly valued members of court. They were appreciated for their lack of guile, for their reputation for speaking the truth in a world of flattery and deceit, and also because they were seen as being close to God.

A c1545 painting at Hampton Court Palace, which supposedly depicts Henry VIII’s ideal family, illustrates the privileged and important roles held by fools at court. In it, Henry is depicted with his three children, Edward, Mary and Elizabeth, and his late wife Jane Seymour. But what is unusual about the painting is that it features two of the court’s fools: Will Somer and, it is believed, ‘Jane the Fool’, fool to Mary.

Henry’s attachment to Somer is well recorded. Bald-headed ‘Jane the Fool’, who had her head shaved up to twice a month, was also a popular addition to court, enjoying many privileges.

None of Henry VIII’s palaces were more important to him than Hampton Court. In the space of 10 years he spent more than £62,000 rebuilding and extending the palace – approximately £18m today.

Visitors to Hampton Court can enjoy a host of activities and learn more about the building’s history and famous inhabitants.


Chiswick House and Gardens, Chiswick, London

Where genteel pursuits were thought to restore sanity

Private lunatic asylums, or ‘madhouses’, had become popular by the 18th century as places in which gentlemen and women could ‘recover their reason’. Run by ‘mad doctors’, who didn’t require medical qualifications, these large country houses provided environments where patients could undertake genteel games and therapeutic pursuits, such as horticulture, until they were well enough to leave. The patients were not kept at such institutions against their will, and were encouraged to walk and enjoy their beautiful surroundings.

“By the 18th century, madness was beginning to be seen as the loss of reason,” says Simon Jarrett, “and it was believed that placing patients in quiet, rural locations would restore their reason. However, this was really only an option for those who could afford it; treatment of ‘pauper lunatics’ could be much worse.”

Chiswick House was run as a private ‘madhouse’ in the late 19th and early 20th centuries, before Middlesex County Council acquired it in 1929. Today, it is known as one of the finest examples of neo-Palladian design in England and for its magnificent landscape gardens.


The Pembrokeshire Record Office, The Castle, Haverfordwest, Pembrokeshire

Where patients were fastened to their chairs and denied comfort

The mid-19th century saw a move to try and assess and control the types of treatment being carried out at private ‘madhouses’ and lunatic asylums. Restraints were a feature of many asylums, and a lunacy commission was formed to inspect institutions.

The Haverfordwest Town Gaol was appropriated for the reception of the insane in 1822 and subsequently declared a county asylum. By 1844 the asylum housed 17 patients but inspectors found it to be totally unsuitable for their accommodation and treatment.

Following a visit to the asylum in 1842, commissioners reported that “the asylum was deficient in every comfort, and in almost every convenience: the rooms being small and ill-ventilated”. They expressed shock that “the dress of the patients was dirty, ragged, and insufficient,” and that “the refractory patients were confined in strong chairs, their arms being also fastened to the chair”.

The former prison buildings, in the castle grounds, are home to the Pembrokeshire Record Office, but the office is soon moving to new premises. Visitors can still visit the remains of Haverfordwest Castle, and the neighbouring museum contains a number of artefacts, including a cell door and leg irons.


Langdon Down Centre, Teddington, Middlesex

Where a pioneering doctor opened a specialist hospital

John Langdon Haydon Down, a doctor from Cornwall, is best known for his description of a genetic disorder now known as Down’s Syndrome. It was Down himself who coined the expression ‘mongoloid’ to describe the condition based on his belief that the facial features of people with Down’s Syndrome were similar to those of people from Mongolia. The discovery that Down’s Syndrome was the result of a chromosomal abnormality wasn’t made until 1959.

Appointed medical superintendent of the Royal Earlswood Asylum for Idiots in Surrey, home to people with lifelong learning disabilities, Down pioneered specialist treatment that advocated education and activity rather than restraints and punishment.

In 1868, John and his wife, Mary, purchased the White House (which still remains on the hospital grounds today) to set up a private hospital establishment known as the Normansfield Hospital.

Down’s goal was to run the hospital as a family home and place of learning for residents. With this in mind, from 1877–79 he built a beautiful theatre where patients could perform shows and hold dances, both of which he deemed to be conducive to good health.

The Langdon Down Centre is the theatre wing of the old Normansfield Hospital and houses the Normansfield Theatre, which is preserved as a rare example of a private Victorian playhouse and contains original painted scenery. The centre is open to the public twice a week.


St Saviour’s Church, Acton London

Where the needs of a deaf congregation were embraced

British sign language as we know it has its roots in ‘the combined system’ developed by Scottish teacher Thomas Braidwood in the mid-18th century, but non-signers often viewed it with suspicion as they couldn’t understand what was being said.

St Saviour’s Church in Acton is a wonderful early example of disability adaptation and was the first church in Britain to be built for the deaf community. The church opened in 1875 in Oxford Street (now home to Selfridges) and featured two pulpits: one for the chaplain and one for the interpreter. Tiered seating and bright lighting meant that deaf members of the congregation could understand what was being said – a unique innovation at the time.

The church moved to its current site in Acton in 1922 to a building designed by Sir Edward Maufe: the foundation stone was laid by the Prince of Wales, later Edward VIII, in 1925. Visitors can attend services at the church or visit on request.


Westfield War Memorial Village, Westfield, Lancaster

Where disabled servicemen could set up home

The end of the First World War saw thousands of disabled servicemen returning to Britain, requiring specialist help and equipment. In a national outpouring of gratitude to those who had sacrificed their health and bodies for the country, appeals were launched to build houses for these returning veterans.

Westfield War Memorial Village is one of many specialist communities built for such a purpose and was opened in November 1924 by Field Marshal Haig. The memorial at the centre of the village depicts a soldier giving his wounded comrade a drink, and is dedicated to all ranks of the King’s Own Royal Regiment, the Lancaster Artillery Battery and all other Lancastrians who had served during the war.


Words by Charlotte Hodgman. The historical advisor was Simon Jarrett, web writer for the English Heritage ‘Disability in Time and Place’ project.