ABSTRACT | PDF
This issue is dedicated to Dr. John Haslam on bicentenary of publication of his book Illustrations of Madness.
In 1810, Dr. John Haslam published "Illustrations of Madness," a detailed study of an articulate, educated patient who believed that his mind was being controlled by a gang of revolutionary thugs operating a secret machine called an "Air Loom." Haslam's landmark treatise about patient James Tilly Matthews earned a place in the history of psychiatry as the first example of an "influencing machine," or as author Mike Jay put it:
"For everyone who has since had messages beamed at them through their fillings, or their TV sets, or via high-tech surveillance, MI-5, Masonic lodges, or UFOs, James Tilly Matthews is Patient Zero."
The Air Loom Gang is a fascinating account of one man's unusual and ultimately tragic life during an age of great political, social and scientific upheaval. Matthews' incarceration at Bedlam occurred amid a fundamental shift in medicine, when doctors first began trying to diagnose and treat madness as a disease, rather than a moral failing or act of God (a movement triggered, in part, by the notorious madness of King George in the late 1780s).
Matthews (1770–1815) was a London tea broker, originally from Wales, who was committed to the Bethlem (Bedlam) psychiatric hospital in 1797, and is considered to be the first fully documented case of paranoid schizophrenia.
In the early 1790s, concerned at the likelihood of war between Britain and France, Matthews travelled to France with the radical David Williams who was acquainted with such Girondists as Jacques Pierre Brissot and Le Brun. Williams made efforts at mediation which failed, whereupon Matthews took the lead. Despite the eccentricity of his statements, he gained the trust of the French government for a short time.
On 2 June 1793 the Girondists were displaced by the Jacobins and Matthews fell under suspicion for his Girondist associations and also because he was suspected of being a double agent. He was arrested and imprisoned for three years during the height of The Terror until 1796 when the French authorities concluded that he was a lunatic and released him.
Returning to London, Matthews wrote two letters to Lord Liverpool, in which he accused the Home Secretary of treason and complained about conspiracies directed against his life. After interrupting a debate in the House of Commons by shouting "Treason" at Lord Liverpool from the Public Gallery, he was arrested and held in a secure workhouse in Tothill Fields, Westminster before being admitted to the Bethlem (Bedlam) psychiatric hospital on 28 January 1797. Upon examination he declared that he had taken part in secret affairs of state (referring to his efforts in France), but had been betrayed and abandoned by William Pitt's administration.
In 1809 his family and friends petitioned for his release, on the grounds that he was no longer insane, but their petition was rejected by the Bethlem authorities. They therefore took out a suit of habeas corpus and two doctors, George Birkbeck and Henry Clutterbuck examined Matthews, declaring him sane. John Haslam, the resident apothecary at Bethlem, begged to differ and maintained that Matthews' delusions, particularly on political matters, rendered him a danger both to public figures and the general public.
In 1810 John Haslam produced the book Illustrations of Madness (original title: Illustrations of Madness: Exhibiting a Singular Case of Insanity, And a No Less Remarkable Difference in Medical Opinions: Developing the Nature of An Assailment, And the Manner of Working Events; with a Description of Tortures Experienced by Bomb-Bursting, Lobster-Cracking and Lengthening the Brain. Embellished with a Curious Plate). Haslam intended to settle the dispute about whether Matthews was insane or not; his book contains verbatim accounts of Matthew's beliefs and hallucinatory experiences and is considered the original description of the symptoms of paranoid schizophrenia. The book was the first full-length study of a single psychiatric patient in medical history and has become a classic in the medical literature.
Matthews believed that a gang of criminals and spies skilled in "pneumatic chemistry" had taken up residence at London Wall in Moorfields (close to Bethlem) and were tormenting him by means of rays emitted by a machine called the "Air Loom". The torments induced by the rays included "Lobster-cracking", during which the circulation of the blood was prevented by a magnetic field; "Stomach-skinning"; and "Apoplexy-working with the nutmeg grater" which involved the introduction of fluids into the skull. His persecutors bore such names as "the Middleman" (who operated the Air Loom), "the Glove Woman" and "Sir Archy" (who acted as "repeaters" or "active worriers" to enhance Matthews' torment or record the machine's activities) and their leader, a man called "Bill, or the King".
Matthews' delusions had a definite political slant: he claimed that the purpose of this gang was espionage, and that there were many other such gangs armed with Air Looms all over London, using "pneumatic practitioners" to "premagnetise" potential victims with "volatile magnetic fluid". According to Matthews, their chief targets (apart from himself) were leading government figures. By means of their "rays" they could influence ministers' thoughts and read their minds. Matthews declared that William Pitt was "not half" susceptible to these attacks and held that these gangs were responsible for the British military disasters at Buenos Aires in 1807 and Walcheren in 1809 and also for the Nore Mutiny of 1797.
In 1814 Matthews was moved to "Fox's London House", a private asylum in Hackney, where he became a popular and trusted patient, the asylum's owner, Dr. Fox, regarding him as sane. Matthews assisted with book-keeping and gardening until his death in 1815.
Although it is impossible to make an unequivocal diagnosis of a long-dead person, Matthews' description of his torment by the "Air Loom Gang" reads as a classic example of paranoid persecutory delusions brought on as part of a psychotic episode. From this, it can be concluded that his disorder was most likely schizophrenia, although retrospective diagnoses should be treated with caution.
It should also be noted that while Haslam kept notes on Matthews, Matthews kept notes on Haslam and his treatment in Bethlem. This formed part of the evidence looked at by a Select Committee of the House of Commons in 1815, the findings of which led to Haslam's dismissal and reform of the treatment of patients in the Bethlem Hospital.
Matthews was also important in the history of psychiatry for more practical reasons. During his involuntary confinement he took part in a public competition to design plans for the rebuilding of Bethlem hospital. Bethlem's governors thought so well of the 46 pages of designs submitted by Matthews that they paid him £30 and the drawings finally used to build the new hospital show some features proposed by Matthews.
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