Bethlem Hospital at St George’s Fields, 1828

James Tilly Matthews (1770– 10 January 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.

The „Air Loom“

John Haslam’s illustration of Matthews‘ Air Loom

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 „premagnetize“ 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 on 10 January 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 £50 and the drawings finally used to build the new hospital show some features proposed by Matthews.