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The article examines how the dominant imagery of the (un)dress of the mad poor in England, from literary, medical and other sources, matches the real conditions of the poor insane as found in institutional and documentary sources between 1650-1850. Researchers examined documentary sources such as clothing procurement for the poor insane as chronicled in parochial records. The accuracy of existing cultural representations is assessed through a case study of the records of Bethlehem Hospital.