Literature and Medicine I

11The spectacle of the madman or madwoman served not only as a moral lesson in the inherent goodness of reason in humanity, but as a form of authorized scopophila in removing the madperson from his or her “easy wandering life.”[4]Much criticism of Foucault’s Madness and Civilization has been based upon translation, specifically, the absence of English translation for the full manuscript, which runs about 600 pages. The English translation is less than half that length based on a 1964 abridged edition. Certain selections, such as the phrase alluded to above “an easy wandering life,” remain contentious. Some critics suggest this interpretation is evidence of a more problematic and faulty use of primary source materials on Foucault’s part. However, I recommend the excellent collection of essays Rewriting the History of Madness: Studies in Foucault’s Histoire de la folie, edited by Arthur Still and Irving Velody, for some enlightening discussion on the subject, specifically Allan Megill’s essay, “Foucault, Ambiguity, and the Rhetoric of Historiography.” In the madhouse, women were viewed with an eye toward appearance and cleanliness, whereas men were viewed with an eye toward restraint and violence. In the Report from the Committee on Madhouses in England, the testimony of Henry Alexander focuses on the confined insane at the workhouse Leskeard in Cornwall. Alexander speaks of the confined madwomen noting their physical condition, chained on dirty straw, covered in filth, dejected, and emaciated (Ingram 252). The examiner did not speak to the women; indeed his entire basis for observation was on one woman’s physical non-conformity to socially acceptable appearance and an unprovable idea of the cause of her madness being an ill-fated love affair. Throughout the report, men are spoken to while confined, such as the infamous William Norris, a man reputed to have been physically restrained in an iron cage for 14 years (249), whereas women were spoken about and described with a focus on their nudity and filth. This reflects Mary Ann Doane’s suggestion that women are continually represented as a body “over-present, unavoidable, in constant sympathy with the emotional and mental faculties, the woman resides just outside the boundaries of the problematic wherein Western culture operates a mind/body dualism” (206). Thus under the male, medicalized gaze, women are only their problematic bodies, where as men are situated against the concern of violence and animality, their higher, reasonable mind separated from the manacled body. 

12Another issue that Porter mentions with regard to Foucault’s application of the great confinement in England that must be addressed is the missing and/or late entrance of the state in the creation of public asylums. As previously stated by Foucault, the move to confine was instigated by the state to penalize and control the idle bodies and unreason of the mad; yet in England, the central authority did not become involved in the creation and implementation of public madhouses until close to the end of the long 18^th century. Porter states that “the ‘great confinement’ was a drive by the powerful to police the poor” yet the poor were never the only class to be confined (Manacles 9). Both Lady Mar (Lady Mary Wortley Montagu’s sister) and Frances Burney’s family friend, well-known poet Christopher Smart, spent time in madhouses despite their confirmed upper-class status (Grundy 281; Abbott 1021). Because of the relatively late involvement of the state and the broad class spectrum of those people confined within either private or public madhouses, this move to confine was based primarily within the local communities. However, I do not find this a sufficient reason to completely discount Foucault’s concept as Porter seems most willing to do. While the move to confine the mad in England was not so much the oppressive police action that Foucault suggests, it was instead a policing action founded at the local community and more importantly at the family level.

13One subject that Porter does not speak at length about is the role of women within the asylum. He does make a caveat that the “male admissions notably outstripped female” until after the 1850’s. He also explicitly states that “Georgian asylum admissions lend no support to the view that male chauvinist values were disproportionately penalizing women with mental disorders, or indeed that the asylum was significantly patriarchy’s device to punish difficult women” (Manacles 163). This was reflective of Samual Tuke’s 1819 design for a pauper lunatic asylum which planned for 150 people with equal distribution of men and women (Edginton 96). While this may be true especially in the early years of the rise in the madhouse trade, I find it difficult to believe that women were treated equitably with men. As Foucault states in The History of Sexuality, the 18^th century saw a shift in gendered views toward women. He saw this shift as the “process whereby the feminine body was analyzed […] as being thoroughly saturated with sexuality; whereby it was integrated into the sphere of medical practice by reason of a pathology intrinsic to it; whereby, finally, it was placed in organic communication with the social body” (104). Thus it is through the process of the analysis of women’s bodies that the changing ideology took place. 

14With the subtle rise in women’s admissions came additional scrutiny of women’s mad-diseases, such as hysteria, previously thought to be caused by a wandering uterus. One explanation for the long popularity of the wandering uterus as cause of hysteria was the widely held belief in the one-sexed body. Prior to the 18^th century, the Galenic, one-sex model dominated both medical and social discourse. The idea of the woman as a flawed man was proven by woman’s inverted male genitals; “you could not find a single male part left over that had not simply changed position” (Laqueur 26). Illustrations from the period exaggerate the similarities; the vagina as the inverted penis, the ovaries as the testicles, etc. In this view, the uterus has no direct male counterpart, which may have led to an acceptance of the wandering womb, that is, in a one-sexed body; the organ that does not have its male equivalent must therefore be an abnormality and likely to wander from it seat in the abdomen.

15In the 18^th century, “as the natural body itself became the gold standard of social discourse, the bodies of women – the perennial other – thus became the battleground for redefining the ancient, intimate, fundamental social relation: that of woman to man” (Laqueur 150). It is with this change, such as when women’s ovaries became medically recognized in their own right as unique reproductive organs instead of female testicles, that the differentiation occurred. This new pathology was apparent in the move to blame hysteria as a “defect of the nerves” being “chiefly and primarily convulsive, and chiefly depends on the brain and the nervous stock being affected” (Porter, Manacles 48). The new concept of hysteria was that of a disease of the female nerves rather than of the body. The new hysteria was considered to be “the disease of a body indiscriminately penetrable to all the efforts of the spirits, so that the internal order of organs gave way to the incoherent space of masses passively subject to the chaotic movement of the spirits” (Foucault, Madness and Civilization 147). The physically wandering womb became an excess of sympathy in organs that were led by “animal spirits” and as such, the previously thought purely physical disease assumed its new status as a mental disorder or symptom of madness (Porter, Manacles 49). As Foucault states, “the entire female body is riddled by obscure but strangely direct paths of sympathy; it is always in an immediate complicity with itself, to the point of forming a kind of absolutely privileged site for the sympathies” thus one organ, affected by a shift in spirit could, in turn, disease its closest neighbor, and so on (Madness and Civilization 153-54). It was because of this shift in the root cause of hysteria, from caused by the womb to caused by “a chemopathology of the spirits and nerves” that men could also become victims of the disease (Porter, Manacles 48). As Porter mentions, although the shift away from the womb-center of the disease, women were still much more likely to suffer hysteria than men: men had their own supposed counterpart in hypochondria (Manacles 48-49).