Mapping the Civic Roles of London’s Royal Hospitals through Digital Humanities

HIS350: Digital Approaches to Pre-Modern Europe

Heather Smith
Mingjingzi Liu Luna
1004542202

August 13th, 2025

I. Introduction of Royal Hospitals

        In early modern London, the term “hospital” did not simply mean a place for medical care but to multi-purpose institution that included charity, confinement, and correction (Simpson, 2022). During the Protestant Reformation, the City of London reorganized these institutions into the “royal hospitals” (Simpson, 2022). After Henry VIII dissolved the monasteries, Edward VI replaced their Catholic foundations with a Protestant system that tied assistance to moral discipline and placed them under civic governance (Simpson, 2022). Across Protestant Europe, the Reformation shifted the relief for the poor from church-run charity to civic institutions that offered aid to those deemed deserving and punished the “undeserving” (Cunningham and Grell 1997, 233). This paper uses digital humanities tools to analyze three of these institutions: Bridewell Hospital, operated as a prison and workhouse for the “immoral”; Bethlem Hospital, which confined those labelled as mentally ill; and Christ’s Hospital, which supported and educated poor children (Simpson, 2022). Despite these different functions, this essay argues that all three hospitals worked toward the same civic goals: to control marginalized groups, display the City’s authority, and use charity and care as tools of social control. To support this argument, MoEML’s interactive map will illustrate how each hospital’s location reinforced its function, Voyant text analysis tool will reveal recurring textual descriptions in historical documents, and a recreated soundscape will immerse the reader in the sensory world of early modern hospitals. 

        The Royal Hospitals system functioned as a civic mechanism for enforcing social order, with each institution designed to manage a different category of the poor under the City’s authority (Simpson, 2022). After the dissolution of the monasteries in the 1530s, much of the institutional structure that had provided charity for the poor disappeared, creating what John Slack calls a “perceived vacuum” in welfare provision (Simpson, 2022). Between 1544 and 1555, the Crown transferred several former religious hospitals to the City of London and granted the city authority over other newly established institutions. This created a unified group of five Royal Hospitals, civic in governance despite their name: St. Bartholomew Hospital, St. Thomas Hospital, Bridewell Hospital, Bethlem Hospital, and Christ’s Hospital (Simpson, 2022). Each hospital was reoriented to treat poverty as if it were an illness, dividing it into categories and prescribing institutional “cures.” Stow’s Survey of London (1598) divided the poor into three categories: the “impotent” (unable to work), the “casual” (temporarily disabled), and the “thriftless” (idle or immoral), with specific hospitals tasked to each. Christ’s Hospital took in orphaned and foundling children from the “impotent” category, St. Bartholomew’s and St. Thomas’s cared for the “casual”, and Bridewell punished and put to work those deemed “thriftless.” Although not directly mentioned in Stow’s introduction, Bethlem Hospital functioned separately as a place to confine those who were considered “lunatickle”. (Stow, 1598, 1). As Cunningham and Grell (1997, 234) observe, this was a decisive move away from Christian duty toward civic poor relief grounded in Protestant moral discipline, where aid was inseparable from supervision, correction, and the reform of behaviour. These hospitals were therefore not neutral sites of care, but instruments through which civic authorities regulated both the bodies and morals of London’s marginalized.

II. Spatial Distribution 

        The placement of each Royal Hospital within London’s urban landscape was deliberate and strategic, using geography to reinforce each institution’s function and to make the City’s authority over marginalized groups both visible and enforceable. Bridewell Hospital was originally built as a palace for entertaining the royal family and stood beside the Fleet River (Smith, 2022). By the Protestant Reformation, Bridewell shifted its role and the Fleet River became notorious as one of the city’s filthiest open-air sewers (Museum of London n.d.). Many tanneries operated along its banks, polluting the water and linking the site to low-status, unpleasant labour (Smith, 2022). Bridewell’s conversion into a prison and workhouse made it a fitting site to confine those labelled idle or immoral and to put them to similar kinds of labour. (Smith, 2022) Bethlem Hospital stood on the edge of Bishopsgate ward, and its cemetery was adjacent to the open space of Moorfields to the west (Mead-Willis, 2022). The cemetery and Moorfields formed a barrier that kept the institution and its patients apart from the surrounding wealthy neighbourhoods. However, the main gate of Bethlem Hospital provided accessibility for visitors, which allowed the public to see the patients without integrating them into elite neighbourhoods (Mead-Willis, 2022). This placement reflects what Christine M. Petto describes as the strategy of locating “places of the forbidden” in spaces that were both marginal and conspicuous, reinforcing segregation while staging the City’s benevolence and control (Petto 2009, 44). Christ’s Hospital, in contrast, was centrally located on the former Greyfriars monastery site near Newgate Market (Hubschman, 2022). This location was surrounded by busy commercial streets that were full of Protestant ideals during the moral reform (Hubschman, 2022). The choice to locate this hospital in the city centre shows the City’s priority on shaping the next generation into morally upright citizens, rather than solely on curing illness. 

        To analyze these hospitals' placement, the digital humanities tool—Agas Maps—makes the spatial relationships between the three hospitals visible in a way that text alone cannot. By applying the map’s category filter (Figure 1), I can easily isolate the “Hospitals” layer, which highlights Bridewell, Bethlem, and Christ’s Hospital in red. Zooming in allows me to explore their immediate surroundings: the polluted Fleet River near Bridewell, the liminal expanse of Moorfields beside Bethlem, and the bustling market streets around Christ’s—each reinforcing the hospital’s role. Using the drawing tools, I created a triangular overlay that connects the three hospitals, demonstrating their relative positions: marginal (Bridewell), liminal (Bethlem), and central (Christ’s), and how these locations matched their respective functions (Figure 2). The various functions of Agas Maps support the argument from the previous section that the Royal Hospitals’ locations were deliberately chosen to enact civic authority through segregation, correction, and relief. The screenshot of this annotated map serves as both evidence and a way for readers to directly perceive the geography of control embedded in the city’s spatial distribution.

Figure 1: Map of Early Modern London. n.d. Agas Map. Showing locations of Christ’s Hospital, Bethlehem Hospital, and Bridewell. Screenshot by Mingjingzi Liu, 2025. https://mapoflondon.uvic.ca/agas.htm.

Figure 2: Map of Early Modern London. n.d. Agas Map. Polygon tool depiction of geographical relations between Christ’s Hospital, Bethlehem Hospital, and Bridewell. Screenshot by Mingjingzi Liu, 2025. https://mapoflondon.uvic.ca/agas.htm.

III. Bridewell: A Palace or Prison

        Bridewell’s dual identity as a former royal palace and a prison made it an essential instrument of civic authority, using confinement and forced labour to reform those considered immoral. Primary sources such as Stow’s Survey of London depict Bridewell not as a charity but as a civic institution serving the interests of London’s governors and citizens (Figure 3), distinguishing it from other hospitals that were devoted to medical care. From Voyant’s document segment view of this primary source, the term “Bridewell” appears closely to “idle,” “poor,” and “worke,” highlighting its role in managing the “thriftless” category and linking enforced labour punishment to their low social status (Figure 4). In John Taylor’s “The Praise and Virtue of a Jail and Jailers”, Voyant’s frequency trends map shows the word “royal” overlaps with “Bridewell,” recalling its past as a palace for the elite (Figure 5). The term “Bridewell” also frequently appears alongside “idle” and “prison,” which frames it as an institution for disciplining the poor. Taylor’s examples—such as “men disloyall” who deserved confinement in a prison “even within a castle royall”—tie idleness to moral failure, disloyalty, and social disorder (Taylor, 1623). This language mirrors Stow’s categorization of the ‘thriftless’ and signals how the institution’s royal past was repurposed to legitimize the City’s power to discipline low-status workers and those perceived as threats.

Figure 3: John Taylor. 2022. Excerpt from The Praise and Virtue of a Jail and Jailers. The Map of Early Modern London, Edition 7.0, ed. Janelle Jenstad. Victoria: University of Victoria. Screenshot by Mingjingzi Liu, 2025. https://mapoflondon.uvic.ca/edition/7.0/PRAI1.htm.

Figure 4: Trends graph created by Mingjingzi Liu, based on Stéfan Sinclair and Geoffrey Rockwell, "Trends", Voyant Tools, accessed August 13, 2025, https://voyant-tools.org/?view=Trends&query=bridewell*&query=idle*&query=poor*&query=worke*&mode=document&labels=true&corpus=15009d542c3775bef926a011d5bcc3eb.

Figure 5: Trends graph created by Mingjingzi Liu, based on Stéfan Sinclair and Geoffrey Rockwell, "Voyant Tools", Voyant Tools, accessed August 13, 2025, https://voyant-tools.org/?view=Trends&corpus=d34897d07715d04b4cf843d260ce93f6.

        

        Contemporary historians expand on these primary source portrayals by situating Bridewell within its physical, legal, and economic context, demonstrating how its disciplinary role reflected patterns of urban governance and poor relief systems in sixteenth-century London. Griffiths situates Bridewell by the “smelly Fleet River” and explains how it evolved from royal residence to a prison and served as the city’s main lockup for crimes, vagrants and domestic offenders (Griffiths 2003, 286). He notes that Bridewell combined a courtroom where governors could hear cases, and it also planned a religious routine as part of its corrective programme for those confined (Griffiths 2003, 287). This dual legal and moral function made it a model for other European institutions, aligning with Taylor’s portrayal of Bridewell as a site of judicial authority. Cunningham and Grell (1997, 235) place this development within the economic reform of mid-sixteenth-century London, observing that the poor laws aimed to combat idleness by compelling beggars and the unemployed to work while also addressing the city’s financial needs. This framework clarifies Stow’s stress on Bridewell as a workhouse, where he notes “vagrant persons be now set a worke, and relieued at the charges of the citizens.” Thus, both historical and contemporary perspectives show that Bridewell’s transformation from palace to prison was not merely functional, but ideological: repurposing royal prestige to legitimize civic authority, control marginalized populations, and present coercion as moral reform.

IV. Bedlam or Madness

Bethlem Hospital, or Bedlam, was portrayed in primary sources less as a fixed building and more as a civic tool for defining and controlling a marginalized social identity marked by madness. In the broadside ballad “A New Mad Tom of Bedlam,” the narrator speaks in the voice of “Mad Tom,” a fictional patient whose rambling mythological fantasy with references to poverty and desires, such as “poor naked Tom” and a request for “a little drink for Charity” (A New Mad Tom, 1658–1664). These phrases pictured Bedlam’s residents as mentally ill, materially deprived, and dependent on charity for survival. Voyant’s analysis of the ballad shows “Bedlam” appearing closely with “mad” and “Tom,” indicating how the institution’s name was inseparably tied to the wandering persona (Figure 6). The accompanying woodcut depicted “Mad Tom” as a ragged, half-clothed man with wild hair, gripping a weapon and seeming ready for a fight (Figure 7). His mismatched clothes suggest both vulnerability and potential threat, echoing Stow’s description of Bethlem as a hospital for the “lunatickle,” like Bridewell’s “idle” category, designated socially marginal individuals (Stow, 1598,1).

Figure 6: Word cloud created by Mingjingzi Liu, based on Stéfan Sinclair and Geoffrey Rockwell, "Voyant Tools", Voyant Tools, accessed August 13, 2025, https://voyant-tools.org/?view=Cirrus&corpus=55d0a7ff5007e180cb65c7c0bd1161b9.

Figure 7: “A New Mad TOM of Bedlam, OR, The man in the Moon drinks Claret, With Powder-beef turnep and Caret.” ca. 1658–1664. EBBA 31797. University of Glasgow Library – Euing Collection. English Broadside Ballad Archive. Accessed August 13, 2025. Screenshot by Mingjingzi Liu, 2025. https://ebba.english.ucsb.edu/ballad/31797/citation.

        

        Contemporary scholarship also views Bedlam as more than a medical facility, but they differ in their interpretation of its social identity. Simon Cross argues that Mad Tom became a widely accepted embodiment of insanity in early modern London, not as a passive sufferer but as an exaggerated, performative figure (Cross 2012, 25). This stereotype, he explains, was part of an evolving cultural performance—shifting from misery to a form of public entertainment as attitudes toward madness changed. Petto, on the other hand, observes that institutions like Bedlam were deliberately made accessible to the public, allowing elites to witness charity in action while also amusing themselves at the expense of those confined for failing to live within accepted social boundaries (Petto 2009, 47). The open gate, as mentioned in the spatial introduction of Bedlam, made the display of the mentally ill as part of the City’s civic function, segregating marginalized groups while presenting that control as benevolence. These perspectives show that Bedlam is a social identity that mixes with poverty, madness and public display, but their different understandings of Bedlam, from Cross’s focus on performance and stereotype to Petto’s emphasis on civic management, underline that Mad Tom remained as a living, adaptable symbol of madness.

V. Christ’s Hospital: Selective Charity and Social Order

        Christ’s Hospital, like Bridewell and Bethlem, serves as a means for the city to manage marginalized groups while concealing its actions as charity. Instead of targeting the “idle” or the “lunatickle”, it focused on orphaned and impoverished children, shaping them into disciplined members of society through education and close supervision. In the Survey of London, Stow describes Christ’s Hospital as a foundation of a former church, housing fatherless, poor children who were brought up and nourished at the expense of the city’s citizens (Figure 8). Another, Voyant’s analysis of the chapter “Of Schooles and other houses of Learning” reflects “Christ” appearing most often with “hospitall,” “schools,” “schollers,” “house,” and “free.” (Figure 9), These collocates highlight the institution’s dual role as a residence and a centre for free education. The appearance of “house” and “free” underscores that this aid came without cost to the children themselves, yet also acted as a civic strategy to produce a morally disciplined and economically useful generation.

Figure 8: Stow, John, and William Fitz-Stephen. 2022. Survey of London (1598): “Schools and Houses of Learning.” The Map of Early Modern London, Edition 7.0, ed. Janelle Jenstad. Victoria: University of Victoria. Screenshot by Mingjingzi Liu, 2025. https://mapoflondon.uvic.ca/edition/7.0/stow_1598_schools.htm.

Figure 9: Collocates table created by Mingjingzi Liu, based on Stéfan Sinclair and Geoffrey Rockwell, "Voyant Tools", Voyant Tools, accessed August 13, 2025, https://voyant-tools.org/?view=CorpusCollocates&corpus=aa2f573c6fcd81fd83f490bd74871591.

        Contemporary scholarship also positions Christ’s Hospital within a system of civic governance that used education and moral training as a method of social control. Claire S. Schen argues that the institution, like other charitable bodies of the time, practiced selective welfare in which admission often depended on parish sponsorship and was limited to “worthy” recipients, while excluding the idle or unruly (Schen 2002, 190). This approach matches Stow’s description of Christ’s Hospital as caring for “poor fatherless children” at the expense of the citizens, reflecting a weight on aiding those who fit civic ideals of deserving poverty while using charity to uphold social order. Their care included education, religious instruction and vocational training, which aimed to uphold Protestant values and obedience, ensuring that the next generation of the poor would become productive and loyal citizens—a crucial goal in this period of social and religious transformation (Schen 2002, 194). By targeting carefully chosen recipients and shaping their moral and economic roles, Christ’s Hospital, like Bridewell and Bethlem, fulfilled the City’s overarching aims: controlling marginalized groups, displaying civic authority, and embedding social discipline within acts of charity.

VI. Digital Humanities Tools Experience

        Pairing with the use of Agas Map, this digital essay also utilizes Audacity, Voyant, and Blogger platform, which transforms this essay from a static analysis into an immersive, multi-sensory exploration of the three chosen hospitals, allowing the readers to see, hear and spatially imagine the civic roles these institutions played in early modern London. With Audacity, I recreated a layered soundtrack using audio from the English Broadside Ballad Archive (A New Mad Tom, 1658–1664) and Freesound.org (Freesound n.d.) to represent the three royal hospitals as a collective (Figure 10). The track begins and ends with “A New Mad Tom of Bedlam” ballad, surrounding listeners with a lunatic’s laugh to evoke Bedlam, talks in the hospital waiting room and the creak of carts to capture medical care. Street riots suggest Bridewell’s role in disciplining the “immoral,” while crying infants and a group of children’s choirs represent Christ’s Hospital. Designing the sequence of the sound allowed me to connect directly to primary sources: searching their key terms in Freesound.org produced audio that reflected each hospital’s role. This process made the early modern world tangible, enabling the audience to hear the atmosphere described in the texts.

Figure 10: Audio soundscape Royal Hospital created by Mingjingzi Liu, incorporating audio samples from Pixabay (n.d.), English Broadside Ballad Archive (n.d.), and Freesound (n.d.). Full details of individual audio files are listed in the references section.

        Voyant supported my soundscape work by highlighting significant word choices in primary sources and revealing how authors such as Stow and Taylor described hospital locations within London’s urban space (Voyant Tools n.d.). The collocates and proximity patterns in Voyant help me to clarify how each hospital was linked to specific civic functions and surrounding areas. It also reinforced the sensory dimension created in Audacity and Agas Map, enabling readers to imagine both the sounds and the spatial context of each hospital. Voyant’s ability to cross-analyze multiple primary sources helped identify recurring vocabularies between each hospital and its surrounding urban space, reinforcing the argument that their physical placement and public image were deliberate tools of governance. Finally, the Blogger platform brought these elements together, integrating Voyant visualizations, the Agas Map, and the Audacity soundtrack into an interactive digital essay. This combination gave readers simultaneous access to the evidence, making the patterns of civic control and public display more immediate and engaging. By moving beyond the limits of a traditional essay, these tools expanded the scope of analysis, encouraged multi-sensory engagement, and provided historians with ways to interrogate both textual and spatial evidence in a unified, accessible format.

VII. Conclusion

        The Royal Hospitals of early modern London—Bridewell, Bethlem, and Christ’s—were far more than charitable institutions. Through their spatial placement, selective admissions, and carefully shaped public identities, they served as civic instruments for regulating marginalized groups, asserting the City’s authority, and recasting charity as a tool for social discipline. Each hospital targeted a different category of the poor, from the “thriftless” to the “lunatickle” to the “impotent,” yet together they formed a coordinated system of control that blended moral reform with public display. The digital humanities tools used in this project deepened and expanded the above argument. The Agas Map made the geography of control visible (Map of Early Modern London n.d.), showing how each hospital’s location matched its social function. Voyant revealed recurring language in primary sources (Voyant Tools n.d.), linking word choice to both the spatial and social positioning of these institutions. Audacity’s soundscape translated textual descriptions into an audible experience, allowing modern readers to hear the atmosphere of confinement, charity, and discipline. The Blogger platform integrated these tools into an interactive space, combining visual, spatial, and auditory evidence to create a multi-sensory analysis. This project showed me how digital tools can turn historical research into an interactive experience that reveals patterns and perspectives traditional essays might overlook. Going forward, I would apply these methods to future historical projects, using digital mapping, text analysis, and soundscapes not only to present evidence but to let readers actively experience the spatial, social, and sensory dimensions of the past.

References

1. Audacity. n.d. “Audacity.” Accessed August 13, 2025. https://www.audacityteam.org/.
2. Blogger. n.d. “Blogger.” Accessed August 13, 2025. https://www.blogger.com/.
3. Cross, Simon. 2012. “Bedlam in Mind: Seeing and Reading Historical Images of Madness.” European Journal of Cultural Studies 15 (1): 19–34. https://doi.org/10.1177/1367549411424949.
4. Cunningham, Andrew, and Ole Peter Grell. 1997. Health Care and Poor Relief in Protestant Europe, 1500–1700. London: Routledge.
5. English Broadside Ballad Archive. n.d. “English Broadside Ballad Archive.” Accessed August 13, 2025. https://ebba.english.ucsb.edu/.
6. English Broadside Ballad Archive. n.d. “Recording of A New Mad Tom of Bedlam (E.248).” Accessed August 13, 2025. https://ebba.english.ucsb.edu/recordings/e.248.m4a.
7. Freesound. 2008. “Metal Jail Door Closing” by InspectorJ. Accessed August 13, 2025. https://freesound.org/s/67279/.
8. Freesound. 2017. “Hospital Ambience” by klankbeeld. Accessed August 13, 2025. https://freesound.org/s/398870/.
9. Freesound. 2018. “Child Crying” by jorickhoofd. Accessed August 13, 2025. https://freesound.org/s/434535/.
10. Freesound. 2019. “Cart Rolling on Cobblestones” by RTB45. Accessed August 13, 2025. https://freesound.org/s/438414/.
11. Freesound. 2020. “Street Riot Crowd” by MAJ061785. Accessed August 13, 2025. https://freesound.org/s/451792/.
12. Freesound. 2023. “Children Playing and Shouting” by felix.blume. Accessed August 13, 2025. https://freesound.org/s/712420/.
13. Freesound. 2024. “Footsteps on Stone” by klankbeeld. Accessed August 13, 2025. https://freesound.org/s/724226/.
14. Freesound. 2024. “Wooden Door Creaking” by InspectorJ. Accessed August 13, 2025. https://freesound.org/s/624709/.
15. Griffiths, Paul. 2003. “Contesting London Bridewell, 1576–1580.” Journal of British Studies 42 (3): 283–315. https://doi.org/10.1086/374292.
16. Hubschman, Brenna. 2022. “Christ’s Hospital.” The Map of Early Modern London, Edition 7.0, ed. Janelle Jenstad. Victoria: University of Victoria. Accessed May 5, 2022. https://mapoflondon.uvic.ca/edition/7.0/CHRI2.htm.
17. Map of Early Modern London. n.d. “Agas Map.” Accessed August 13, 2025. https://mapoflondon.uvic.ca/agas.htm.
18. Mead-Willis, Sarah. 2022. “Bethlehem Hospital.” The Map of Early Modern London, Edition 7.0, ed. Janelle Jenstad. Victoria: University of Victoria. Accessed May 5, 2022. https://mapoflondon.uvic.ca/edition/7.0/BETH1.htm.
19. Museum of London. n.d. “Lost Rivers: The Fleet.” Accessed August 13, 2025. https://www.londonmuseum.org.uk/collections/london-stories/lost-rivers-the-fleet/#:~:text=London's%20largest%20hidden%20river%2C%20the,city's%20stinkiest%20open%2Dair%20sewers.&text=A%20watercolour%20view%20of%20Fleet%20Ditch%20by%20Thomas%20Hosmer%20Shepherd.
20. Petto, Christine M. 2009. “Mapping Forbidden Places and Places of the Forbidden in Early Modern London and Paris.” Environment, Space, Place 2 (1): 35–59.
21. Pixabay. n.d. “Cell Door.” Accessed August 13, 2025. https://pixabay.com/sound-effects/search/cell-door/.
22. Schen, Claire S. 2002. “Charity and Social Control, 1580–1620.” In Charity and Lay Piety in Reformation London, 1500–1620, 186–230. London: Routledge. https://doi.org/10.4324/9781315260631-13.
23. Simpson, Lucas. 2022. “Hospitals in Early Modern London.” The Map of Early Modern London, Edition 7.0, ed. Janelle Jenstad. Victoria: University of Victoria. Accessed May 5, 2022. https://mapoflondon.uvic.ca/edition/7.0/HOSP1.htm.
24. Smith, Caitlin. 2022. “Bridewell.” The Map of Early Modern London, Edition 7.0, ed. Janelle Jenstad. Victoria: University of Victoria. Accessed May 5, 2022. https://mapoflondon.uvic.ca/edition/7.0/BRID2.htm.
25. Stow, John, and William Fitz-Stephen. 2022. Survey of London (1598): “Hospitals.” The Map of Early Modern London, Edition 7.0, ed. Janelle Jenstad. Victoria: University of Victoria. Accessed May 5, 2022. https://mapoflondon.uvic.ca/edition/7.0/stow_1598_hospitals.htm.———. 2022. Survey of London (1598): “Schools and Houses of Learning.” The Map of Early Modern London, Edition 7.0, ed. Janelle Jenstad. Victoria: University of Victoria. Accessed May 5, 2022. https://mapoflondon.uvic.ca/edition/7.0/stow_1598_schools.htm.
26. Taylor, John. 2022. Excerpt from The Praise and Virtue of a Jail and Jailers. The Map of Early Modern London, Edition 7.0, ed. Janelle Jenstad. Victoria: University of Victoria. Accessed May 5, 2022. https://mapoflondon.uvic.ca/edition/7.0/PRAI1.htm.
27. Voyant Tools. n.d. “Voyant Tools.” Accessed August 13, 2025. https://voyant-tools.org/.