Please use these notes for historical context for my book The Asylum Doctor's Daughter. 
Spoiler alert: These notes will give away plot points from my book Infirmity. 

Placing Kat in Seven Dials was a risk. This was one of the toughest places in mid-nineteenth century London, and most people didn’t choose to go there. As in Kat’s case, Seven Dials was where one with nothing tried to survive. It was a cruel and dangerous place, and everything I wrote to describe it is based on first-hand accounts: dead babies in lodging houses, boys from Italy forced to sing for money who would probably never see their parents again, the farming of poor children by their parents, the bludgeoning of Irish and English workers, and so on. 
I gave only a glimpse of the harshness of The Dials in Victorian London. The details of its reality were far worse, particularly the treatment and lives of prostitutes. The cruelty and violence which accompanied the prostitution world of The Dials were at times horrifying to read, and I left many things out of this book. The treatment of women both in Victorian and modern times is certainly an area society in all parts of the world has failed in, and it is my hope that cruel and inhumane treatments will be eradicated soon.
The Bruce House and Old Clothes Exchange are based on real places. In my research, I learned of lodging houses set up like The Bruce House with separate male and female rooms and a conjugal room in between, as well as shared kitchen and living areas. The Old Clothes Exchange was just as depicted in Infirmity: a large room with stalls lining its perimeter and also filling the middle. Items were exchanged for money and most things were accepted, even shoes without matches.
The George Street baths were as depicted, even down to the front office selling penny soap. This would have been a place for someone in Kat’s economic situation to bathe when she could afford it.
Bethlem Royal Hospital is as depicted in this story as in historical accounts, both in its physical layout and practices. Dr. Hood was an extraordinary doctor who brought reform to a hospital that had been in the habit of dehumanizing and torturing its patients. He created a warmer and more humane environment. Bath sessions became a practice in the more reformed years of Bethlem, often submerging patients in hot, and sometimes tepid, water. It would not be uncommon for a patient like Kat to have received this.
Eliza Crapp is a well-known patient of Bethlem, particularly in regards to her role in Charles Darwin’s study on the commonality of facial expressions in a work called “Expression of Emotions in Man and Animals.” Photographer Henry Herring, the same one mentioned in this book, took Eliza’s picture, which was later requested by Darwin for his work. 
Mr. Richard Dadd, another infamous Bethlem patient, was an artist whose mind told him his father was the devil and should be destroyed. He was a criminal asylum patient, held in a secure ward on the back grounds of Bethlem, after killing his father. He was granted permission to paint while incarcerated and produced magnificent pieces of art. He spent twenty years in Bethlem, then was transferred to Broadmore Hospital for the Criminally Insane, where he lived out his final days. It was here he wrote a poem titled, “Elimination of a Picture & Its Subject - Called The Feller’s Master-Stroke.” This poem was written about his painting “The Fairy Feller’s Master Stroke.” 
As mentioned in my notes in Disorder, suicide was prevalent in Bethlem and unfortunately is not uncommon among people today. If you feel thoughts toward hurting yourself, please call the National Suicide Prevention Lifeline at 1-800-273-8255. Your life matters. 
Yardley Green Street Sanitorium in Birmingham was a smallpox epidemic outbreak hospital which opened in 1895. One of the reasons I chose to turn this sanitorium into a tuberculosis hospital was its location on the London and North Western Railway. It seemed plausible that James would choose to send Andrew somewhere fairly close and accessible. I based the sanitorium on Mundsley hospital, which was opened by Dr. F.W. Burton-Fanning and also on a tuberculosis hospital in Poland, opened by Dr. Hermann Brehmer.
Tuberculosis and cholera were feared and vicious diseases in Victorian London. Another long-standing disease threatening people, although usually not considered fatal, throughout the ages was typhoid fever. In fact, Queen Victoria’s husband, Prince Albert, contracted the disease in 1861 and died of its complications twenty-two days later at the age of forty-two. It would not be unreasonable to suggest a character at this time would contract typhoid fever.
The Alhambra was a circus hall before becoming a music hall (and subsequently also a more scandalous venue). In the spring of 1860, it was still the circus, offering a pleasant and exciting final excursion for James, Kat, and Mr. Freeman. It gave them the chance to experience life outside of Bethlem safely before venturing out on their own into a world unfamiliar. The circus was fascinating to read about, and a part of me wishes to base an entire book there. We shall see. :) 
Victorian Bethlem viewed its patients as people, one of the remarkable contributions of Dr. Hood. In fact, he eventually had a family and allowed his children to run free on Bethlem grounds, mingling with patients. Charles Dickens asked his friend Henry Morley to visit the hospital and record what he saw. Concerning the patients, he wrote, “The sufferers [patients] feel that surely they are not cut off from fellowship with man, not objects of a harsh distrust, when even little children come to play with them, and prattle confidently in their ears.” 
There is something to be said of little children.

​