An 1847 annual report for Aberdeen Lunatic Asylum shows the various reasons for people’s admission. These were split into two categories, which was fairly typical – physical and moral. The physical reasons, listed first, included old age, head injuries and intemperance while the moral reasons included anxiety, death of relatives and disappointment in love.
Drink too much tea
If you were a woman in the 19th century, virtually anything could get you committed to an insane asylum—including drinking too much tea. NHS Grampian Archives dug up this admissions record from the Aberdeen Lunatic Asylum in the United Kingdom. The table contains data on causes of admissions categorized by sex. In addition to those admitted to the asylum for “prolonged nursing,” “poverty,” or “disappointment in love” (neatly, one man and one woman in that category!), one woman arrived at the asylum only to have her problems blamed on “sedentary life—abuse of tea.”
Luckily, someone at the archives tracked down more details on the patient and posted the case notes on Facebook. Elizabeth Collie, a 34-year-old factory worker, was admitted in November 1848 after suffering from delusions, specifically delusions about machines. Her files state that “she imagines that some species of machinery has been employed by her neighbors in the house she has been living in, which had the effect of causing pain and disorder in her head, bowels, and other parts of the body.”
Asylum employees noted that ”no cause [for her condition] can be assigned, except perhaps the excessive use of tea, to which she has always been much addicted.” She was released in June 1849.
A letter to the editors of The British Medical Journal in 1886 suggests that the suspicion of women’s tea-drinking habits was not unique to Aberdeen mental health institutions. One doctor, J. Muir Howie wrote to the publication:
Would you kindly allow me to draw attention to the fact that, among women at least, the abuse of tea frequently leads to the abuse of alcohol! My experience in connection with a home for inebriate women has led me to this conclusion. Many of the inmates, indeed, almost all of them, were enormous tea-drinkers before they became victims to alcoholic dipsomania. During their indulgence in alcohol, they rarely drink much tea; but, as soon as the former cut off, they return to the latter. In many instances, alcohol was first used to relieve the nervous symptoms produced by excessive tea drinking.
Put down that tea-cup and back away from that teapot.
Beside “abuse of tea”, an intriguing reason for admission given by Aberdeen Lunatic Asylum in the 1840s was “vegetable poisoning”. Alexander Sinclair, a 36-year-old from Inverurie (spelled ‘Inverury’ on the image) admitted on 19th April 1849. It details the background to his admission, and that there doesn’t seem to be any known cause for it until he gives what he thinks may be the reason.
His case notes show that “he believes the cause of the attack to have been drinking a decoction of herbs which he prescribed himself but cannot give a very intelligible account of what the herbs were.”
Alexander was discharged as ‘Recovered’ on 30th May 1849, but was re-admitted in 1865 after falling ill again. More experimentation? He was then discharged again as ‘Recovered’ on 1st January 1866.
By the early 1800s, European and American physicians agreed that masturbation led to insanity. Because sexual arousal involved stimulation of the nervous system, the chronic nervous excitation attending the unnatural act of masturbation might eventually undermine the health of the brain.
The “solitary vice” was considered worse than partnered sex. The practice of masturbation was likely to start at an earlier age and to occur more often. Most important, the lack of a partner meant resorting to fantasy and the conjuring of erotic scenes and lewd images that surely stirred the brain to a fever pitch. Because the brain’s inflamed state could be transmitted to any organ or tissue of the body through the nervous system, all manner of disease could follow. But with sexual solitaire, the climax was insanity.
Look out for these signs
“…the wretched transgressor sinks into a miserable fatuity, and finally becomes a confirmed and degraded idiot, whose deeply sunken and vacant glassy eye, and livid, shriveled countenance, and ulcerous, toothless gums, and fetid breath, and feeble broken voice, and emaciated and dwarfish and crooked body, and almost hairless head—covered, perhaps, with suppurating blisters and running sores—denote a premature old age—a blighted body—and a ruined soul!” – Sylvester Graham (1794-1851)
The diseases attributed to those admitted to the Trans-Allegheny Lunatic Asylum in West Virginia hospital included forty to fifty patients for: “intemperance,”, “ill health,”, “menstrual,” “traumatic injury,” and “masturbation.” One honest man was listed with “masturbation for 30 years.”
After investigation of the patients who were admitted for reproductive organ concerns, it could be found that these women had reoccurring symptoms in months prior to admittance, usually occurring around the same time each month!
The admittance records of the women in Mendota Mental Asylum in Madison Wiconsin (who possessed the symptoms) showed a trend of experiencing so-called ‘attacks’ of insanity one to two weeks a month.
Not menstruating was also risky! The suppression of menses was also a diagnosis given to women of many different ages. Patient 1000 at Mendota Mental Asylum was diagnosed at age 17 with insanity by suppression of the menses and Patient 1364 was diagnosed at age 46 with insanity by suppression of the menses resulting from age. The younger patient may have been pregnant or suffering from an eating disorder. Meanwhile, the older woman was probably going through menopause.
One frequent symptom for admission was religious excitement. This symptom included such actions as “delusive on subjects” “religious fantasies,” and “foolish romantic talk about the devil and Jesus.” Many of these (mostly) women had differing beliefs from the rest of society, and their spiritual viewpoint stood out among others.
In 1853 Mr. Eccleston, the Superintendent Surgeon of Rainhill Lancashire County Lunatic Asylum , ‘observed’ that patients most were admitted mostly due to ‘drunkenness and perverted ideas on religion….minds shipwrecked on the rocks of religious fatalism’. (Information taken from President of Medical Society in London – Journal of Psychological Medicine and Mental Pathology 1853).
One patient might think that she was God, and another patient’s beliefs were just different from those of her church community. Both were admitted to a mental asylum with the same diagnoses.
Mrs. Packard was a teacher in Jacksonville, Illinois, and the mother of six children when her husband committed her to the state hospital. He admitted her because she disagreed with his religious beliefs as a pastor. After experiencing two years in a state mental hospital as a sane person, Mrs. Packard took her case to trial to prove her sanity. The court agreed with her and in freeing her from the hospital, led to her efforts to divorce her controlling husband.
Although she could have stopped there, Mrs. Packard continued her battle for women’s rights. Until her death, she fought for married women’s rights by lobbying in the state legislature and writing books about these rights and her personal fight.
Fits of Laughter
Women were deemed insane by reason of “hysteria” when they experienced delusions, uncontrollable fits of laughter without cause, the feeling of being inclined to do mischief or a tendency to use abusive language toward others.
In the nineteenth century, the idea of “nervous diseases” transformed into a new disease, called “hysteria.” Stemming from the Greek word for “uterus,” hysteria was immediately presented as a solely feminine ailment. Any activity of the uterus, specifically menstruation, childbirth, or sexual intercourse, was thought to accentuate a woman’s vulnerability to hysteria, in the same way that sensitive nerves and general emotional instability would.
Hysterical fits were recognized first by their barrage of emotional and physical symptoms, ranging from heart palpitations, fits, choking, laughing, fainting, and second, by the quick transition from one symptom to the next. Although some physicians argued that hysteria was directly linked to abnormal sexual activity, the disease was generally understood to result from emotional sensitivity or “nervousness” on a fundamental level.
By the 1860s insanity linked to prolonged breastfeeding was an established category of asylum admission. As John Conolly M.D. was to note, in 1856, of his patients at Hanwell Asylum, a number of women had been engaged in ‘protracted nursing’ and were semi-starved on their admission. ‘Cases of mania from protracted nursing, together with deficient nourishment, are not, it is well known, unfrequent”
Puerperal melancholia (what we would call “postpartum depression) was also thought to be ‘caused by the debilitating effects of suckling’, and was sometimes known as ‘insanity of lactation’.
Puerperal Melancholia was a form of insanity which appeared some weeks after childbirth Beginning commonly with a dislike or suspicion of husband, nurse, and others around her, it is often accompanied with suicidal impulse and sometimes with the impulse to kill the child. It’s striking that melancholia was particularly associated with ‘depressing moral influences such as the husband’s unkindness.’
Also included as the causes of this form of ‘insanity’ are ‘worries about servants, or other domestic chagrins and anxieties’. (Presumably, poverty may be regarded as one such anxiety.)
Henry Maudsley in “The Pathology of Mind…” suggests that it is ‘essentially an insanity of exhaustion and preceded usually by such neurasthenic symptoms as headache, ringing in the ears, dimness of vision, neuralgias, and a very weary feeling of weakness’
However, the cure was obvious. What these women needed to recover was rest. Maudsley also advises husbands not to make sexual demands of their wives whilst they are recovering. At the time, the average English wife had half-a-dozen children, and almost twenty percent had ten or more children.
Overexertion was a diagnosis of insanity for many women. Of the women diagnosed with overexertion at Mendota Mental Asylum, it was found to be common for a family to consist of seven to eight children. Normal household duties including cooking, cleaning, and raising the children all fell upon the women’s shoulders.
Many women were not able to handle these changes after numerous births, which lead to another medical diagnosis given frequently at Mendota Mental Asylum: childbirth. Patient 2268 was 22 when she delivered her first child and experienced an attack of incoherence and constant fear her child was being hurt. She was later diagnosed as insane by childbirth. This woman was possibly experiencing the equivalent of what is diagnosed today as postpartum depression. While childbirth was common among diagnoses, insanity by abortion was also found among a significant amount of patients (Box 3, Mendota Mental Health Institute Patient Records).
One symptom was depression after the death of a loved one. For women, if the depression continued to last longer than the woman’s family deemed an acceptable period of grieving, the depression became grounds for admittance to the asylum.
Where we would suggest bereavement counselling, this depression was seen at the time as the precursor to insanity.