The Suffering of Women Who Didn't Fit: 'Madness' in Britain, 1450–1950

2018

Introduction

Abook such as this is, by necessity, little more than an introduction to the wide, changing subject of women and madness. Detailed and enriched though it is by cases and personal thought, it provides not a medical aetiology but a well-informed history of gender, insanity and socio-cultural responses. Its focus, however, is undeniably women who experienced the brutalities of madness over five hundred years. Many, no doubt, might expect a rigid chronological approach yet the subject, to this author at least, lacks a fair spread of material and would hide the real issues that define women and madness.

Thus Chapter 1, Engendered Madness, isolates often generic responses to the female ‘Other’, those suffering ‘madness’, and assesses instead what it meant to be labelled insane on account of her genes. From defining her gender to periodic control, domestic confinement to breaking her chains, almost all of her suffering came from the misogynist male.

In Chapter 2, The Hysteria Hysterics, the origins of this, its most famous eruption, are investigated, not just in the Victorian Age when it reached its nadir, but from much earlier times, starting with Hippocrates’ wonders at the ‘wandering womb’. We also look briefly at what it means to women today.

Chapter 3 takes her gynaecological make-up, a persistent focus, as the signal curse of her mind. Through each life-stage, from pre-menstruation to postmenopause age, madness found its peak in the volatility of child-birth, and the rearing that followed. Maternal Mayhem gives eye-watering accounts blended with the hopeless concern felt by those ‘unfortunate’ women who brought new life into the world.

In Chapter 4, Correcting Women, the male domination of lunacy ‘treatments’ through the ages invented and resurrected a series of mental, physical, even spiritual interventions of the most invidious kind. From natural remedies to

the cruellest of surgeons, each concocted response was designed for ‘moral correction’.

Summarising many of the points addressed in these earlier chapters, Chapter 5, Suffering Women, encapsulates the woman’s lot in a world where she endured mind-based abuse. From her pre-ordained role as home-maker and brood mare, to a wife and companion, she was expected to be a goddess near the hearth and a (reluctant) whore in the bedroom. Like a fragile machine, designed for a purpose, she was driven by man and corrected when broken. In short, it coalesces the wide-ranging points revealed through this book.

Throughout history, dangerous warnings and means of restraint have kept women and madness as inseparable cousins. By employing religion, politics, medicine and law – not to mention social designation – those deemed strange or unstable were kept under control. Running through its centre, like a poisonous snake, the so-called ‘golden thread’ of non-reason, the female gender.

Not that for women it was bad all of the time. The same jaundice that denounced women as weaker also force-fed her great pity, leading to countless escapes from the rigours of law and social revenge. The distaste for hanging women, for example, reached its peak in the mid-nineteenth century – precisely when infanticide cases seemed to reach their crescendo.

Nor does the past hold a monopoly on misogynist errors. In the present, too, it is too easy to misread social and political landscapes, drawing errorstrewn readings no matter how inadvertent they seem. This book takes no account of typically recent developments in gender or sexual identity, including transgender and asexual selections. Rather, its remit is to present the experience of women as biologically defined. Perhaps one day, another will follow that takes into account such wide social and gender-based alterations; one, for instance, that focuses on the generations who followed the present work’s focus.

Nor does it escape the author’s awareness – and fear – that this work cannot but be written through male (if not overtly masculine) eyes. Though they may wear a lens of empathetic feminism, ever-changing political ideals and social corrections present a trap into which the unwary male must fall. Such men who have ever broached this mercurial subject have unavoidably written of notions they could not thoroughly grasp. Yet has the reader too been affected by the sex of the author – is he, to them, a narrator or the protagonist still? In short, if I have been guilty of causing offence, I beg the reader’s forgiveness for, in fact, the opposite intention was true.

This notwithstanding, it is my historian’s objective, with a love for the subject, to draw together not a collection of cases, but to accumulate a set of influences, guiding principles and thought - often irrational - which have hijacked this most formidable topic during the past five hundred years.

Setting the Scene - Time, Madness and Women: three clinical themes

By covering half a millennia of ‘reason’, the current work has set itself the unenviable task of making sense out of the fluid and nonsensical – vacillating, temporary ways of viewing the world – and with them the confusing plethora of insanity labels, each causing those looking back to see either more clearly or, more often, to submerge beneath a thickening mist. Faced with recognised historical terms, such as Regency, Enlightenment, Renaissance and more, we have settled here on the more familiar arrangement: Medieval (1450-1600), Post-Medieval (1600-1700), Early Modern (1700-1830), Modern (1830-1900) and Post-Modern (1900-date). Such terms are, of course, liable to become intertwined, but a Herculean effort has been made for their consistent application throughout the whole of the text.

From this most basic of segregations, it will be seen how each era was ascribed its own trajectory of suffering and illness. Gender historian, Ludmilla Jordanova, wrote of periodic epidemics that have been used to define the prevailing social condition: ‘each century is characterized by a great illness: leprosy – thirteenth century; black death – fourteenth century; syphilis – sixteenth century; and in the nineteenth century it was the ulcerated womb of women … that summed up the epoch’.¹

Added to this list, indeed pervading through time – as Victorian alienist, Daniel Hack Tuke lamented – the mad, dear things, have always been with us. Each epoch thus chose its own means to define them; and its own ways to respond. Such stark reassessments, whether gentler or harsher, owed more to their mindset than conditional change. The medieval Bedlamites were a real example: these unconstrained mad ‘licensed’ to beg on the streets around Bethlem, were at one time sorely pitied with money yet, three hundred years later, extolled as the eponymous Byronian muse.²

Tuke’s own impressive Historical Sketch of the Insane³ provided a neat, if at times overly-poetic drawing of madness and the reactions it drew through eons of time. As he related, human responses to madness and its unique

diagnoses were amended in stages since men (sic) first trod the Earth. From those Early Medieval disruptive humours, to demonic possession; the supernatural fears that defined a post-medieval; such that each eventually gave way to an Early Modern self-harm (or, immoral behaviour that led to nervous decay). A later, so-called ‘hysterical age’ brought its own wealth of conditions, as General Paralysis of the Insane (GPI) was blamed on lax nineteenth century pleasures.

The real situation was seldom clear-cut. Seventeenth century attitudes, for example, conflated several ‘causes’. Religion, morality, sin, madness and gender all featured strongly; to experience a defect in one must have meant disrepair in another. In a pre-Victorian absence of organised treatments and institutional centres, save Bethlem and Norwich, early madness was beholden to extant social mores.

Instead, it was the people themselves who ‘diagnosed’ madness – who recognised its cases as ‘different’ – and responded in line with prevailing socio-cultural beliefs.⁴ And yet, as so often, it was the women who suffered.

As Macdonald observed, religious beliefs and secular notions (the two halves of human existence) were easily blurred. So that ‘the spirit of evil’ met with ‘the malevolent humours’, to produce ‘disturbing emotions’ in the greatly disturbed.⁵ Both natural and supernatural forces were freely accepted, for at least half of the timeframe this study observes. It explained the otherwise ‘inexplicable’ and anti-social behaviour, as astrology, astronomy and a belief in the Devil kept each remained rooted in diagnosing the mad.⁶

Down the centuries, ideas about women became no more forgiving, caught in a whirlpool of changing beliefs in the human condition. Ferocious debates on religious, secular and natural science defined successive eras of the mad female kind. Over half a millennium, religious teachings gave way to a reformed secularization, while scientistic expression emerged from the wings of human endeavour, and yet each paradigm shift offered little for her.

Then by the end of this new work’s chronological focus, there came a prosaic acceptance of being alive – as the mind, body and spirit were reduced to a collection of cells. Yet still, in the female context, little had changed except to get worse.

It is surely apt that the patron saint of the insane is a woman. Saint Dymphna, supposedly a high-status seventh century Briton, who was brutally murdered by her own unchristian father after he himself was heard to go mad. St Dymphna’s Disease has ever since become euphemistic for madness.

In both pre- and early industrial societies, female madness was always acknowledged, if not its true cause or the rightful response. A key feature of how these ‘mad’ women were handled was how madness itself was seen to exist. It was possible, perhaps inevitable, that the subject’s conversion into, say, the seventeenth century witch-hunts, revealed more about ignorant pseudo-religious beliefs than any clinical insight they may have claimed to behold. One thing was sure; it left women at the mercy of a powerful few – men.

Consistent attitudes to women and their place in the world offers only a parallel yet converging account with equally unsettling evocations. The unerring belief in the corruptibility of her gender had led to little abeyance in the male’s need for control. It led not just to cruel and barbaric responses, but to an array of self-serving, self-interested male diagnoses of what it was to be ‘mad’. Which is what we turn to right here.

From Humours to Wombers

It began from the earliest eons; from Hippocrates’s belief in the four humours – phlegm, blood and yellow and black bile – to Galen’s refined theoretical form. The dominance of each was believed to reveal a differing temperament in the human condition; so that a phlegmatic person was stoic and calm; biliousness brought on melancholia (black) or irascibility (yellow); while the over-heated blood also produced a short temper and irritable nature (choleric).⁷

So how did this relate to mental well-being and the earliest responses from the medical world? As Andrew Scull expertly apprised, from fevers to delirium (historically seen as cause and effect), ‘emotional and cognitive dysfunctions’ were blamed on a humoral imbalance. But not even the ancients found a consistent approach:

‘Where Aristotle had seen the heart as the seat of the emotions and of mental activity, Hippocratic texts saw the brain as their centre: men ought to know that from nothing else but the brain come joys, delights, laughter and sports, and sorrows, griefs, despondency, and lamentations…

‘If it was the head, not the heart, which ruled, the emotions, the encephalon was also where madness lurked: It is the brain too which is the seat of madness and delirium, with the fears and frights which assail us often by night but sometimes even by day; it is there where lies the cause of insomnia and sleep walking, of thoughts that will not come, forgotten duties and eccentricities. All such things result from an unhealthy condition of the brain…when the brain is abnormal in moisture it is necessarily agitated.’⁸

Nonetheless, it was the humours which governed mental disruption: ‘too much blood [warmed] the brain, too much phlegm…[produced] a mania’. Too much black bile made a man (sic) melancholic – from the Greek melanchole, literally black-bile.⁹

From such somatic origins for mental conditions, it was perhaps inevitable that a woman’s body should attract particular terror. The one thing she had, which of course all men had not, was her womb. Adding her supposed colder, moister condition, misogynist foundations were laid for her reputation as the inferior kind. To paraphrase Woods, women a long time before the nineteenth century were considered to suffer psychological problems simply because of their feminine nature.¹⁰

The world now had its earliest distinction in mental and emotional trauma: mania; melancholia; and the hysterical female (from hystericus, Latin for womb). Even later medics, like George Cheyne and his belief in frayed nerves being the root of all evil, drew humoral theory into their clinical thought:

‘I never saw a person labour under severe, obstinate, and strong nervous complaints, but I always found at last, the stomach, guts, liver, spleen, mesentery or some of the great and necessary organs or glands of the belly were obstructed, knotted, schirrous, spoiled or perhaps all these together.’¹¹

Yet without exception all would be challenged, cajoled, refined or dismissed, over the centuries that came.

A new direction of suffering and shame betrayed a continuous descent for the decried female gender. From the earliest expression of the volatile woman, through seventeenth century torture and being burned at the stake, the eighteenth century hostess of hell and damnation, to the Victorian expectation of the ‘Angel in the House’ (from Coventry Patmore’s nineteenth century poem), to think for herself meant being labelled not only mad but deviant too.

To paraphrase again, this time Macdonald, in short ‘[each] century was a disaster for the [female] insane.’¹² It was no great surprise that a woman became the heiress of misfortune; outwardly troublesome, the pitiful sex. ‘Medically unique but inferior… [her] health was determined by her femininity.’¹³

In the 1700s, both the Enlightenment era and the earlier Age of Reason had placed mad women in a negative light shared by other sources of shame: ‘crime, vice and idleness’ (including now women) were unreasonable, unreasoned, the very antithesis of nature (Bynum et al 1985: 80) to which they were supposed to belong. To be stable and sound, a woman was expected to conform to a ‘norm’ – that she was a product of fate, destined to breed and to represent nature.

Another hundred years on and a new breed of ‘experts’ – psychiatrists and alienists – now named specifically female ‘insanity’ conditions: hysteria; puerperal; uterine; and menstrual madness. Procuring the supposedly volatile sex to attain their own professional acceptance, in an uncertain place in these mutable times. Perhaps like never before, save the dark years of torturing witches, a redefinition of woman was attempted for society’s ‘gain’. Who they were, what made them tick and, above all, what to do when they failed, became a pivotal point in the alienists’ world.

But the ones who knew themselves best – these ‘fragile women’ – had no option but to buy into it all. In this nineteenth century especially, popular opinion saw women who rejected their domestic existence risked being declared insane and committed to an asylum.¹⁴

But quite how had this appropriation of female madness come to take hold? In the late eighteenth century, the nature of madness was decidedly male; such as Cibber’s statues of mania and melancholy that poured out their angst over old Bethlem’s doors. In time it gave way, to a gentler, vaguely eroticised image, as madness became a typically female curse:

‘In the course of the [eighteenth] century…the appealing madwoman gradually displaced the repulsive madman, both as the prototype of the confined lunatic and as a cultural icon.’¹⁵

The significance of the latter is reflected in this book’s literal focus, as has been her descent into a blatant sexualisation of the female insane.

So was it all down to sex? One could be tempted to say so, were its biological meaning included, for out of such focus, madness reform proved to be a patriarchal response to the pitiable gender. While some could be classed as real advancements, like famed French physician, Philippe Pinel, who ‘freed the insane’;¹⁶ or American psychiatrist Isaac Ray’s bucolic approach to treating the mentally ill.¹⁷ One undeniable example was the Quaker Retreat. Opened in York in 1793, its appearance reacted to unacceptable horror. After the mysterious death of a female inmate at the maligned local asylum, and she being a member of that peaceable group, the Tukes led by William, the redoubtable father, devised and developed their safe haven of sorts.¹⁸. That the victim was female was not unconnected.

A Woman’s Lot in the World - an Early Discussion

Underlying this book is the treatment foisted upon and suffered by women, in particular those condemned to have lost use of their senses. Built too often on sand, all contributed to a woman’s lot in the world. Such miserable truths are abridged in the following themes.

Firstly, her requisite role in bringing new life to the world, that rendered her unstable and dangerous due to her gynaecological riddles. From her adult development, ‘a time of great stress’, to her regular periods as a young, fertile woman; then ‘heavy with child’ and her hormones supremely chaotic, never more so than soon after birth when her mind was left wayward by her recent expulsion; or post-menopausal when she was further unhinged; all were yet more crudely translated into mental conditions. Phrases like maternal disquiet, monthly mayhem, the hysterical or the troublesome womb, removed her from the domestic home and the hearth to the lying-in hospital or worse the asylum. Yet only because the apothecary, the cleric, medicine, science and law, not to mention her family, said the strain was too great for her embattled mind to withstand.

Second to come, and indirectly related, rose the spectre of domestic confinement. As the ‘Crimean Angel’, Florence Nightingale had much earlier wailed, ‘the confinement of women in the family [compared] to the circumstances of the lunatic in the asylum.’¹⁹

The all-too-lately acknowledged source of mental decay, the same home and the hearth, became a breeding ground for despair, of rebellious outbursts and misdiagnosed eruptions like the hysteric attack. And spawning new ailments, like uterine madness, or redefining the past such as neurasthenic despair.

Underpinning it all came the panic-struck male, frightened of masculine failure as much by the loss of her love, the very thing they most treasured: the source of their comfort, society and having a woman at home. The result was distasteful: an Englishman’s home may well be his castle, but it too often served as the woman’s impregnable cell.

For eons perhaps, yet never more obvious than during the long nineteenth century, the misogynist will had given women their rules. In all living matters – mind, body and soul – a woman could not think, say or do without seeking permission or being unfairly judged. From mental to physical and melding the two, control ruled then as it had threatened to do. The witch-hunting horrors might have belonged in the past, but her voice and her mind were still under restraint.

As Ben Griffin, author of The Politics of Gender, so eloquently though perhaps a little myopically bludgeoned: ‘[There were so] many ways in which women in the nineteenth century [and elsewhere] were oppressed by [the family and] laws that systematically and deliberately served the interests of men’ (2012: 4). Expectation and law, with often unspeakable punishments, were simply designed kept the little woman at bay. And from this preposterous position, a woman’s lot was defined. From the bedroom to the kitchen, the parlour to the hearth, Patmore’s housebound angel was here to stay.