It was a London landmark so famous, tourists would visit it alongside Westminster Abbey and the zoo; so notorious, the very name came to mean madness and chaos. It inspired countless poems, dramas and works of art. And the building it was housed in from 1676 appeared so opulent that it was compared to none other than the Palace of Versailles.

This was Bethlem Hospital, more commonly known by its nickname (and the word adapted from it): Bedlam. Almost from the start, Bethlem was much more than a mental asylum. “It was a landmark in the City of London, right by Bishopsgate, and it was also one of the very first to specialise in people who were called ‘mad’ or ‘lunatic’. It becomes this proverbial, archetypal home of madness,” says Mike Jay, author of the book This Way Madness Lies, published to accompany the exhibition Bedlam: the asylum and beyond now at London’s Wellcome Collection. “Any asylum is called a ‘bedlam’ quite early on. Then it becomes a generic term, and then it’s something that means more than an asylum – there are all these metaphors of the world being ‘a great bedlam’.”

Like many old hospitals, Bethlem began as a religious order; it was founded in the 13th Century as a priory dedicated to St Mary of Bethlehem. By 1400, it had become a medieval “hospital” – which then didn’t imply medical care, but simply meant “a refuge for strangers in need”, Jay notes. Those with nowhere else to go turned up at the priory’s doors.

Over time, Bethlem began to specialise in caring for those who weren’t simply poor, but also incapable of caring for themselves – particularly those considered ‘mad’.