Psychiatry in pictures

The eight dramatic plates of Hogarth's Rake's Progress tell the lurid tale of a young man destroyed by a financial windfall. The hero, Tom Rakewell, could be any of us caught in what Hogarth regarded as the great folly of his time — affectation. Having squandered two fortunes, Rakewell journeys through gambling, drunkenness, venereal disease and imprisonment for debt before reaching the most degrading and terrifying destination imaginable — admission to Bethlem Hospital. His head has already been shaved and an attendant fastens a leg-iron as Rakewell lies on the floor of the hospital gallery, his position copying that adopted by the large statues of Melancholy and Raving Madness that sat above the gates of Bethlem and would have been well-known to Londoners. Hogarth has used Rakewell's fellow patients to represent the sins and follies of both the rake and the world in general. Thus, the mad tailor reflects vanity, the enraptured religious maniac — abuse of religion, and the naked man with a crown — lust for power. The man with a telescope and the figure drawing on the wall behind him are a couple of longitude lunatics — engaged in a futile attempt to solve the lucrative puzzle of the age. In the middle of all this chaotic misery an elegant lady and her maid who have paid to view the patients look on with amusement. Although there is much about the picture that is clearly from Hogarth's imagination, his depiction of the arrangement of the gallery and patients' cells is accurate and the image remains the best window we have into the interior of the hospital at this period. The miserable, sunken-eyed figure on the left of the picture looks very convincingly depressed — he also has the attention of a black dog — and may well have been drawn from a patient observed by Hogarth during one of his visits to the hospital. The image in oils is reversed in comparison with the more widely known engraved plate as a consequence of the engraving process employed by Hogarth. The picture is reproduced by courtesy of the Trustees of Sir John Soane's Museum.

William Hogarth (1697-1764) A rake's progress: the rake in Bedlam (1735)