Literature and Medicine I

16This new view of hysteria as a disease of the nerves rather than as a physical ailment led to mockery by some as affectation. In 1728, a physician bemoans the trend of patients assuming the currently popular disease: “the old distemper call’d Melancholy was exchanged for Vapours, and afterwards for the Hypp, and at last took up the now current appellation of the Spleen […]” (Porter, Manacles 86). Although hysteria was performed by some women because of its popularity in society and literature, there were however genuine sufferers. Mary Wollstonecraft is said to have suffered from “spasms and disordered nerves, constant nervous fever, a melancholy misery, accompanied by violent pains in her side, difficulties breathing, trembling fits, a rising in the throat (globus hystericus) and faintness” (Porter, Manacles 244). Porter reasons that the large numbers of women who suffered from hysteria were due to the fact that “being vapourish or hysterical were roles (sick roles) which women themselves sometimes adopted – as, of course, did men – to give vent to their feelings and to cope with life’s demands” (Manacles 106). Similarly, in Hystories: Hysterical Epidemics and Modern Cultures, Elaine Showalter states that “hysteria is a mimetic disorder; it mimics culturally permissible expressions of distress” (15). Thus, in assuming the role of hysteric, women were able to express their frustration with their life in a culturally acceptable form. As Showalter notes, “throughout history, hysteria has served as a form of expression, a body language for people who otherwise might not be able to speak or even admit what they feel. In the words of Robert M. Woolsey, hysteria is a ‘protolanguage,’ and its symptoms are ‘a code used by a patient to communicate a message which, for various reasons, cannot be verbalized’” (7). If used as a protolanguage, when the hysteric is afflicted by globus hystericus, he or she is expressing, in a culturally permissible manner, the anxiety caused from the previous psychical trauma.

17Hysteria became not just a disease that women were susceptible to, but rather a disease of women due to their new status with the break from the one-sexed body of man. With this change was the new understanding of hysteria as a woman’s disease transmitted by nerves and sympathetic organs, allowing it to firmly enter the realm of symptoms of madness rather than physical illness. In furthering the move of the hysteric as a victim of nerves and excessive sympathy to the hysteric as the victim of previous, though unknown, psychical trauma, in the 19^th century Freud and Breuer helped to delegitimize hysteria as a disease of the nerves and instead helped transform it exclusively to a disease of the unconscious mind. Breuer and Freud cite as proof that hysteria was the result only of a previous trauma when they found “that each individual hysterical symptom immediately and permanently disappeared when we had succeeded in bringing clearly to light the memory of the event by which it was provoked and in arousing its accompanying affect, and when the patient had described that event in the greatest possible detail and had put the affect into words” (Strachey and Freud 6). Thus Freud and Breuer were able to effectively “cure” the hysteric, something that was not even hoped for when physicians studied it in the 18^th century. 

18Another example of this ideological change was the underlying current of a feminization of illness in George Cheney’s treatise, The English Malady. Cheney does allude to the previously popular fluid imbalance theories in his work, but this treatise is significant because of his critique of social life as partly responsible for mental distress. He cites the “continu’d Luxury and Laziness” due to improved English prosperity as one of the primary seats of mental distress (Ingram 85). Likewise, Cheney blames the rich preparation of food as a cause for disturbance (86). Both the language he uses for the effeminate melancholy male and the domain of woman, that is, the preparation and display of food, serves to further demonize women.  His essay appears to be written for men exclusively, not for men as the universal as in the one-sex model of society, but to men at the exclusion of women. Cheney’s document illustrates the new two-sex model through his appeal to men exclusively and the critical eye toward effeminate traits and functions. 

19Another interesting example of the female body within the asylum in the long 18^th century is the Report from the Committee on Madhouses in England from 1815. When commenting on the wretched state of patients in Bethlem Hospital, Mr. E. Wakefield notes typical abuses such as a male patient being chained by the neck to a trough, yet the abuses suffered by the female patients focus on their exposed bodies. He briefly mentions that in the women’s galleries women were shackled to the wall, but instead discusses, at length, their state of undress: “the nakedness of each patient was covered by a blanket-gown only; the blanket-gown is a blanket formed something like a dressing-gown, with nothing to fasten it in front; this constitutes the whole covering; the feet even were naked” (Ingram 247). The extreme interest and supposed shock in the nudity rather than the state of bondage of the female Bethlem patients is notable when contrasted to previous notions of the female body in the one-sexed society.  Indeed the female body was frequently illustrated as nude, genitals exposed, and partially flayed in midwifery and anatomical manuals such as Estienne’s Dissection series of illustrations (Laqueur 131-32). Importantly, illustrations of the flayed and eviscerated male body were equally eroticized as the female because they were of the same sex. It was only after the female body became medically categorizable and obtained its status as a separate sex that it became an object to be protected from view. 

Women Writers and Mad-Discourse

20Above even reason, the great confinement was about policing space; the placement of mad-bodies, the proper place for female bodies, the construction and regulation of asylums, all a function of the hope for the installation of correct behavior. Through the late 18^th century, the mad as a population were not separated by gender. The 1815 report on madhouses notes that women and men were separated into gendered rooms where they were manacled together, but they were allowed mixed free time depending on the severity of their lunacy.[5]The true gendered separation within the asylum did not occur until the 19th century. Bethlem Hospital, the premier and best-known of English asylums, planned for entirely separate male and female wards, separated by a central station (Bethlem Royal Hospital). This is reflected in Eliza Haywood’s description of the madhouse in The Distress’d Orphan, or Love in a Madhouse (1726). In the Distress’d Orphan, the protagonist Annila is wrongly confined by her uncle because she would not marry his son so that he could inherit her estate. In order to free Annila, her lover Marathon has himself committed in the same madhouse to assist with her escape. Especially relevant for this study is Haywood’s detailed commentary on Annila’s incarceration in the madhouse in comparison to Foucault’s idea of the ideal institution. Foucault suggests that the pinnacle of the transition in the control of bodies in the classical age is Bentham’s Panopticon. The Panopticon was a means of correct training by employing a normalizing gaze making it the “perfect disciplinary apparatus” (Discipline and Punish 173). Haywood’s madhouse, however, does not reveal an early concept of the Panopticon but instead develops an image of the anti-Panopticon. It is through the possibility of being under observation at any time that the patient or inmate adapts his or her behavior, internalizing the means of correction and allowing the observer to control behavior from a single point in space. Key to this process is the architecture of sight; the inmate must be easily visible at all times. This was impossible in Haywood’s madhouse, as frequent mentions are made of the dark, dank, secluded apartments into which the patients were confined (50). When Marathon initially encounters Annila after his admission to the madhouse, he barely recognizes her because of the dim conditions (57). For Haywood, the private madhouse in which Annila was confined was a return to the dungeon which was intended “to enclose, to deprive of light and to hide” (200). The private madhouse was not intended to cure or even to incite correct and socially acceptable behavior, but to hide the inconvenient away. Because of the awkward placement of the rooms, the dark environment, and the enforced solitude of the patients, the dungeon is the Enlightenment’s anti-Panopticon, suggesting that popular conception of the madhouse in women’s writing did not clearly align with Foucault’s analysis of the trend. It is important to note that the development of asylum construction was not the all-pervasive explosion as previously thought because it continued to compete with homecare and private madhouses. Beginning in the late 18^th century, asylums were constructed more with an eye toward correction than incarceration, with attention paid to pastoral scenery and rooms designed to assist with mental coherency (Moran and Topp 9). Haywood, however, reflects a contemporary belief in the madhouse as a relatively private place of confinement, rigidly adhering to the social class separation.