“Insanity in individuals is something rare — but in groups, parties, nations and epochs, it is the rule.”
— Friedrich Nietzsche, German philosopher
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With the “scientifically” supported belief of eugenics in vogue, twenty-three states had enacted forced sterilization legislation by 1928 in the United States. Hereditary determinism was the justification for these actions. The reductionistic thinking of the time allowed people to believe that better breeding would result in a better human race, and conversely, poor genetic stock would lead to a deterioration of the same. Such flawed thinking led not only to the forced sterilization of thousands but to the discrimination of those deemed to be of “inferior stock.” Eugenics also led to the ultimate horror of the Nazi “final solution.” Sterilization was claimed to be necessary for eugenic reasons and was implemented in the name of patient “treatment.”
Other flawed ideas were justified with scientific support, becoming interwoven with the society of the time. One of those theories of the day was a psychological disorder called hysteria. Women who were outside of social and emotional standards were said to suffer from this condition. A French physician, Pierre Briquet, detailed the condition in his Treatise on Hysteria, published in 1859. He rejected the theory that frustrated sexual desires led to hysteria and instead believed the condition was located in the brain.
“He claimed that there was a strong family predisposition, although environmental factors were also important in the etiology of this condition. Further he believed that although hysteria was prevalent predominately in women, it occurred although rarely, in men.” [1]
Textbooks and journals of the time brought scientific legitimacy to the support of a mental disease called hysteria. People who had emotions, thoughts, or actions that were considered outside societal norms could be classified as having this mental affliction. Dr. John Clarence Webster wrote about hysteria in his textbook Diseases of Women – A Text-Book for Students and Practitioners, published in 1898. He described those suffering from hysteria as being easily excited, deceitful, having poor judgment, and having perverted sexual emotions such as “abnormal yearning for love.”
“Hysteria is a condition in which especially the higher nervous centres are at fault. Chacot calls it a psychic disease. According to Havelock Ellis, the general character of the mental phenomena in hysteria may be summed up in the word suggestibility. There is an abnormal degree of response to suggestion in the nervous system… Judgment, accuracy, and power of concentration are weakened. The emotions are easily excited and badly controlled. There is a morbid desire for the sympathy of others; she craves attention continually, is full of caprices, and makes excessive demands about her. As Wendell Holmes says, ‘she is a vampire who sucks the blood of the healthy people about her.’ If she is checked or chided in any way, she takes offence, gets irritated, bursts into tears, or has an attack of pain, paralysis, or some other manifestation of the hysterical condition. There is often a tendency to tell untruths and to practice deceptions. Clouston has pointed out particularly the changes due to the loss of inhibitory influence on the reproductive and sexual instincts. There may be various perversions of sexual emotion, e.g. abnormal yearning for love.” [2]
Stepping outside of what was considered normal for the male-dominated society of the time could result in a hysteria diagnosis. Laughing and then crying, laughing at an “inappropriate” time, or other unacceptable emotions were all incorporated into the disease definition. Dr. William A. Hammond published Diseases of the Nervous System in 1871, explaining the hysterical condition.
“A large volume might be written on hysteria – and many such have been published – and there would still be points in the clinical history unconsidered. It is difficult, therefore, in a general treatise like the present, to give a full view of a disease which plays so important a part in nervous pathology… Mental Symptoms – These are very various, but generally consistent in emotional disturbance, an inability or indisposition to exert the will… Attacks are often characterized by no other prominent symptoms than those connected with mental action, and may assume every possible character. At times, the patient is depressed in spirits, and sheds tears profusely; a few minutes afterward, she has forgotten her grief, and laughs immoderately, without adequate cause. Sometimes she laughs and cries at the same time” [3]
Dr. Hammond describes how hysteria occurred in those who did not display a “proper” emotional reaction. The definition of “proper” was colored by the structured societal construct that there was a limited range of acceptable behavior.
“… [exhibits] an emotion the exact opposite of the proper one excited. This is quite a common form of manifestation. A mother, for instance, is informed that her daughter has contracted an improper marriage and is immediately seized with immoderate laughter, and shows every expression of pleasure, when the rest of the family are overwhelmed with grief and shame.” [4]
Dr. Joseph Collins, a professor of nervous and mental diseases at the New York Postgraduate Medical School and a visiting physician at the New York City Hospital, mixes in the popular concept of eugenics. In scientifically sounding terminology, he claims that Jews were especially predisposed to hysteria as well as other “hereditary, degenerative, and nervous diseases.”
“Hysteria is a psycho-neurosis, characterized by disorder of the will, perversion of the inhibitory powers of consciousness, and by partial cessation or exaltation of individual functions of the brain… The most modern view considers it a psycho-neurosis, and associates its genesis with profound neuropathic or psychopathic heritage as a predisposing cause… In later years, it is a relatively common disorder in hospital as well as in private practice of our large cities. This is due to the enormous influx of the Jewish race, whose members are particularly prone to the manifestations of this as well as all other hereditary, degenerative, nervous diseases. Hysterical individuals are degenerates, but a large number belong in the category of superior degenerates than of inferior degenerates.” [5]
Dr. James Tyson described hysteria as a problem with the nervous system. He believed that hysteria was more prevalent in certain races but noted that information showed that it not to be exclusively a disease of women. Hysteria in males was believed to be more common in boys, with masturbation being held to blame for many cases.
“Hysteria is a morbid state of the nervous system, in which may be manifested every variety of nervous system due to deranged function of the cerebral, basal, and spinal centres; associated with lowered will-power and exaggerated emotional tendencies. Hysteria is a disease of civilization and of certain races. It is unknown in the barbarian, and is rare in Northern races, while the volatile Southern temperament favors its development. Thus the French and Italians of the Latin race furnish many subjects, while it is rarer among Germans, English, and Americans. This disease is also frequent among Hebrews. Fully 20 women have hysteria to one man. The sexual organs of women have been held responsible for this… but recent studies tend to show this conception is erroneous. In males the disease takes more the form of hypochondriasis, but in them also convulsions, contractures, and paralysis occur. It is found in boys rather than adult males because of the greater impressibility of the nervous system in the young… Masturbation and adherent prepuce [abnormality in the skin covering the penis] are held responsible for many cases in boys.” [6]
One of the treatments for hysteria in the 1800s into the 1900s was hysterectomy, which is a surgical procedure to remove all or part of a woman’s uterus. In an 1890 article in the Journal of the American Medical Association, the author details physical as well as psychological reasons for the removal of the “uterine appendages.” The psychological neuroses included “Mania, menstro-mania, nympho-mania, epilepsy, hystero-epilepsy, convulsions, cramps, dancing fits, hysteria.” [7] The author states that while hysterectomy is used to treat hysteria, other treatments could be used that were equally effective while preserving “a woman’s every function.”
“Hysteria, with its hydra-headed manifestations, has afforded a prolific field for the practice of this procedure [hysterectomy].” [8]
Because some believed a woman’s hysteria was tied to the uterus, it became an accepted practice to remove the organ assumed to be causing the problem. From The Albany Medical Herald 1905:
“If it can be said that any one thing bothers the general practitioner, it must be that peculiar nervous condition called hysteria. One who has a large practice, especially over quite a rural territory will find any number of these cases… Deriving its name from the uterus, our forefathers were not far wrong in associating this malady with the disorders of that organ or its nervous associates. Many cases have gone to the operating table to get relief, and some have been relieved. Curettements [surgery to remove growths from a bodily cavity], hysterectomies, ovariotomies [ovary removal], etc., have been performed galore, and will be continued to be performed for this trouble after months of worry on your and the family’s part.” [9]
Although men could sometimes suffer from this condition, women were considered to be the ones mainly afflicted because of their emotional nature and inferior reasoning abilities. Doctor Charles D. Fox describes this in his textbook Psychopathology of Hysteria published in 1913.
“Because of their inherent emotionalism and relative inferiority in logical reasoning and philosophical acceptance of the various inevitable stresses of life, females are more susceptible to hysteria than males.” [10]
Treatments in lunatic asylums were essentially various forms of torture. Restraints of all types were adopted simply to subdue and quiet patients. An 1885 report shows the awful conditions in New York asylums endured by those labeled as suffering from hysteria.
“Cages, iron chains, handcuffs, hobbles, straps, crib beds, and fixed chairs, are common modes of restraint of patients, who, being afforded no means of occupation, or diversion for mind or body, naturally become noisy and troublesome. The bath, either shower or immersion, is a favorite means of tranquilizing excited patients. In the cupboard shower bath the patient is subjected to a continuous downpour of water, and this, in some cases as a punishment at the option of the attendants, without the sanction of the medical officer. In the covered hot bath, the head alone protruding, the patient is confined, unable to move, from one to twelve hours at a time, and in many instances unattended, at a temperature of 34 degrees centigrade [93° F], often with cold water dripping on the head… In one institution I saw 215 women in various modes of restraint – camisoles, wristlets, straps, etc. – secured upright in racks round the day rooms. In another there were 43 women in box beds, ironed hand and foot, and extended in spread-eagle fashion, at three in the afternoon.” [11]
People who were deemed insane and institutionalized were often severely neglected. Dr. Edmund Andrews of Chicago, who worked with cadavers obtained from Cook County Asylum in Chicago, commented that the bodies procured from the asylum were often so covered with vermin and filth that they would need to scorch the bodies before allowing students to dissect them. Dr. S. B. Clevenger commented in 1889 on the state of the Cook County Asylum.
“There has been repeated testimony that lice abounded in the wards, and Dr. Koller, an assistant physician, found maggots in the wounds of neglected patients in 1884. Bedbugs would torture patients under their straight-jackets and rats would mutilate bodies of those who had died during the night.” [12]
In 1880, an investigation by a New York State Senate committee brought to light the abuses in insane asylums. Mrs. Hugh Gobel testified that her brother had been sent to Bellevue Hospital in 1879, where she had found him tied hand and foot to a bed with nothing but a wet sheet covering him. He had been left like that all night, shivering. He was later transferred to Ward’s Island, where she visited her brother again on Saturday.
“‘I found him in a room with eight cribs in it,’ said the witness with much feeling. ‘He was tied down in one of the cribs, hands, feet, and arms, and had a great strap bound tightly across his chest. He was in great suffering, especially from the strap across his chest, and begging me in piteous accents to cut it. His tongue was black and swollen so that he couldn’t get it out of his mouth. I put my hand on his forehead and tried to quiet him, but he only pointed to the strap, and cried to me to cut it. I couldn’t bear to see him that way, and ask the attendant if they couldn’t do something to ease him.’ He said ‘Oh he’s got pneumonia!’ I should think he would have it with his flannels stripped off and tied down under a wet sheet with the cold night air pouring through the window. I was told I could see him again Sunday, and when I got there I met the attendant at the door. He said ‘We carried your brother down stairs and hour ago.’ He came to the asylum Thursday and was dead on Sunday.” [13]
An 1894 article published by the New York Times detailed the horrors the “insane” could suffer in asylums. Dr. Louise G. Rabinovitch testified before a State Commission in Lunacy on the conditions of the Verplanck Hospital.
“The Verplanck Hospital, on Ward’s Island, consisted of ten bare halls, each of which is a living tomb for about sixty patients. In them they sleep and sit, and the places are each lighted by two kerosene lamps hung from the door knobs or put on the floor, and always accessible to the most dangerous lunatic. In such squalor, danger, and depressing surroundings the patients end every dreary day at twilight. The dormitories, the witness said were so inadequate to their population that the beds, ranged in rows, touch each other, and the occupants, in retiring, climb over the foot rails. The bathing facilities were scanty, six rusty baths accommodating 880 patients… The cells were described as dark and noisome. The air was vitiated and unhealthy, and the place was unfit for sick people. The branch is generally dilapidated, the woodwork rotten, and the ceilings dangerous.” [14]
The mainstream press also reported on hysteria. Husbands who suffered from the “hysterical” woman used popular home treatments such as dumping a bucket of water on the head of the “patient” or locking the “patient” in a room while going to call on the nearest “pretty girl.” These home remedies were considered effective in treating women suffering from this condition. An article from the New York Times 1878:
“Hysteria was never a popular disease, but it was always simple and straightforward. Its symptoms were marked, and no husband or physician could mistake them… The disease… belonged to the class of diseases produced by unsatisfied longings for bonnets, jewelry, and other things dear to the female heart. It was frequently produced by jealousy and that congenital hatred of and disbelief in, ‘the lodge’, which is a characteristic of married women. It usually began with a tendency on the part of the patient to become rigid and to fall upon the nearest and softest piece of furniture. She – for as is well known the diseases always attacks women – would then cry and laugh by turns, while constantly denouncing her husband as a brute and demanding either to be allowed to die or go home to her dear mother. The state of rigidity was soon succeeded by a well-developed tendency to kick, and in many instances this was followed by the throwing of things – stove-lids and things – at the unfortunate husband. The attack generally lasted from an hour to six hours, and rarely seemed to be benefited by any medicines which a physician could prescribe. Experienced husbands usually tried one of two remedies…which were often highly successful. One was throwing a pail of water over the patient, and the other was locking her alone in her room and going out to call on the nearest pretty girl.” [15]
The racism of the time also led some to believe that certain races were more susceptible to the hysterical condition than others. Low intelligence, high emotions, and even “religious excitement” were considered factors in the disease. Dr. Philip S. Ray wrote in his article “Hysteria in the Negro” published in 1888:
“To the physician in every-day practice the affection clinically resolves itself into a functional nerve trouble, the whole nervous system, during the attack, being excessively sensitive, the principal cerebral trouble being a weakening of the will. Hammond tells us that he has been informed that hysteria was almost an unknown disease among negroes during the slave period. I think the observer who informed him must have been mistaken, for we find the most typical cases of hysteria in the negro during religious excitement, and these scenes were certainly common during the ‘slave times.’ Their low form of intelligence and their emotional nature are both favorable to the disease.” [16]
Calls by women for equality during the early 1900s led some to claim that their actions were a result of hysteria. New York Times 1908:
“The shrieking sisters who chained and padlocked their bodies to the grille of the ladies’ gallery of the House of Commons, and then uttered shrill cries, which led to their removal by the police… were clearly the victims of a recognized form of hysteria. That they and others like them among the vociferous woman suffragists of Great Britain have reached their hysterical state by deliberately planned action does not alter its pathological significance… There is a great danger that hysteria of the same violent kind may soon possess the female suffragists in this country.” [17]
Women of the era were considered abnormal if they showed any sexual desires. Women who showed an excessive sexual yearning could be labeled with a psychological disease of nymphomania. This form of “insanity” could result in a woman being committed to a lunatic asylum.
“I should say that the majority of women (happily for society) are not very much troubled with sexual feeling of any kind. What men are habitually, women are only exceptionally. It is true, I admit, as a Divorce Court shows, that there are some few women who have sexual desires so strong that they surpass those of men, and shock public feeling by their consequences. I admit, of course, the existence of sexual excitement terminating in nymphomania, a form of insanity that those accustomed to visit lunatic asylums must be fully conversant with; but with these exceptions, there can be no doubt that sexual feeling in the female is in the majority of cases in abeyance, and that it requires positive and considerable excitement to be roused at all…” [18]
A footnote in this article on nymphomania shows that surgery was considered for this “complaint” that women suffered from.
“I shall probably have no other opportunity of noticing that, as excision of the clitoris has been recommended for the cure of this complaint, Köbelt thinks that it would be necessary to remove the whole of the clitoris in nymphomania…” [19]
Dr. Bernard S. Talmey, Gynecologist at Yorkville Hospital, describes nymphomania in a 1907 article published in the American Journal of Dermatology and Genito-Urinary Diseases. Dr. Talmey clearly believes that this condition suffered by women caused them to ignore moral and social constraints, leading the woman into a life of “sin.”
“The nymphomaniac woman loses control and can not restrain herself from coition or masturbation. She becomes absorbed in sexual gratification. The best and most careful rearing of girls suffering from nymphomania can not save them from downfall. In their wild passion, casting all moral and social considerations aside, they throw themselves into the arms of sin. The more they abandon themselves to the gratification of their lust the greater is the desire of the morbidly irritated sexual nerve-centers for lecherous satisfaction.” [20]
It was believed that women who turned to prostitution did so because of their insatiable need to have sex because of their nymphomaniacal condition. Excessive masturbation was considered an obvious sign of this disease. Many who were labeled with this diagnosis ended up in mental institutions. Dr. William J. Robinson discusses nymphomania in his 1913 work A Practical Treatise on the Causes, Symptoms, and Treatment of Sexual Impotence and Other Sexual Disorders in Women.
“Nymphomania is insatiable sexual desire in women. It corresponds to satyriasis in men. The unfortunate victims of this disease are often forced to become common prostitutes in order to be able to satisfy their desires. If they cannot get natural satisfaction, they masturbate excessively. Many of them end in the lunatic asylum. Sometimes nymphomania is the initial symptom of a severe psychosis. One of the saddest cases of nymphomania that I know of was in the beautiful daughter of a well-known physician. The mother was also apparently somewhat of a nymphomaniac, but the condition assumed an extreme form in the daughter. She would accost and force herself upon her father’s patients, and the father had to move from place to place. She finally entered a house of prostitution, where she later committed suicide by throwing herself out of a third story window.” [21]
Because increased sexual desires in women were considered by the dogma of the time as a mental disorder, the sufferers of this “disease” would, of course, need “treatment.” Confinement, continuous cold baths, drugs of the day, and even removal of the sex organs through surgery were all considered acceptable therapy for those with “nymphomania.”
“…1000 patients; twenty in restraint; two in seclusion (nymphomania) for two years!” [22]
“The treatment of nymphomania is similar to that of satyriasis: Confinement, continuous cold bath or pack, immense doses of bromide and chloral and morphine if necessary. Removal of the clitoris may be considered. I consider even removal of the ovaries justifiable, if we could be sure of satisfactory results. Unfortunately we cannot, for nymphomania like satyriasis, is of cerebral origin, and the removal of the chief sexual gland may not accomplish any noteworthy results.” [23]
The scientific belief that women suffered from mental diseases because they did not conform to strict social structures resulted in thousands of women being confined to lunatic asylums. The prevailing thought was that many cases of insanity in women were related to disease of the uterus. This 1883 article published in The Dublin Journal of Medical Science noted that 50,000 women had been imprisoned in lunatic asylums because they had been labeled as “insane” by an excepted psychiatric diagnosis of the time.
“…the fact that insanity in women has become doubled in frequency during the last 25 years, and ascribed this to the increase in uterine disease. He related some remarkable cases of hysterical insanity which were cured by the ultimate recognition and treatment of uterine disorder. There was no doubt whatever that among the 50,000 female patients now secluded in lunatic asylums, there were many cases of supposed incurable insanity which were really only the results of unsuspected uterine disease…” [24]
The belief in hysteria wasn’t merely a blip in medical history; it was a reflection of a broader, deeply flawed worldview held by a predominantly white, male-dominated society. Interpreting reality through a narrow, biased lens, they constructed a catchall diagnosis that turned nonconformity—especially among women—into pathology. Women who dared express sexuality could be diagnosed with the so-called “disease” of nymphomania, subjecting them to barbaric treatments, drug regimens, invasive surgeries, or, worse, indefinite confinement in asylums. Inside these asylums, “treatment” often meant enduring unimaginable cruelty, from forced restraint to torturous procedures. These practices, sanctioned under the guise of medicine, reveal the horrifying extent to which society used pseudoscience to control and punish those it deemed “deviant.”
[1] T.E. Weckowicz and H.P. Liebel-Weckowicz, A History of Great Ideas in Abnormal Psychology, Elsevier Science Publishers, 1990, p. 116
[2] John Clarence Webster BA., MD., Diseases of Women – A Text-Book for Students and Practitioners, The Macmillan Company, 1898, pp. 137-138
[3] William A. Hammond, MD, Diseases of the Nervous System, New York: D. Appleton and Company, 1871, pp. 619, 621, 622
[4] William A. Hammond, MD, Diseases of the Nervous System, New York: D. Appleton and Company, 1871, pp. 619, 621, 622
[5] Joseph Collins, MD, The Treatment of Diseases of the Nervous System – A Manual for Practitioners, William Woods and Company, 1900, pp. 422-423
[6] James Tyson MD, The Practice of Medicine – A Text-book for Practitioners and Students with Special Reference to Diagnosis and Treatment, P. Blakiston, Son & Co. 1897, p. 1070
[7] E.E. Montgomery, MD, “The Indications for, and Limitations of, The Operation for the Removal of the Uterine Appendages,” Journal of the American Medical Association, Vol. XIV., February 1, 1890, p. 145
[8] E.E. Montgomery, MD, “The Indications for, and Limitations of, The Operation for the Removal of the Uterine Appendages,” Journal of the American Medical Association, Vol. XIV., February 1, 1890, p. 146
[9] The New Albany Medical Herald, May 1905, p. 90
[10] Charles D. Fox MD, Psychopathology of Hysteria, The Gorham Press Boston, 1913, pp. 34-35
[11] The Medico-legal Journal, New York, 1885, Vol. III, No. 1, p. 123
[12] S.V. Clevenger MD, “The Cook County Insane Asylum,” The Medical Standard, Vol. VI. July 1889, p. 3
[13] “Investigating Asylums. Witnesses Tell of insane People Who Died in Cribs,” The New York Times, December 7, 1880
[14] “Patients in Living Tombs. Dr. Rabinovitch Tells of the Insane on Ward's Island. State Commission on Lunacy Hears Her Evidence as to Verplanck Hospital - Unfortunates in Squalor, Danger, and Depressing Surroundings - Cells Dark and Noisome - Horrors of the Branch - Bad Food Certified Good Through Fear of Dismissal,” New York Times, June 8, 1894
[15] “Improved Hysteria,” New York Times, August 8, 1878
[16] Philip S. Ray MD, “Hysteria in the Negro,” The Medical Record – A Weekly Journal of Medicine and Surgery, July 14, 1888, pp. 39-40
[17] “Hysteria and Woman’s Rights,” New York Times, October 30, 1908
[18] William Acton, MRCS, Functions and Disorders of the Reproductive Organs in Childhood, Youth, Adult Age, and Advanced Life, Seventh Edition, P. Blakiston, Son & Co., Philadelphia, 1888, pp. 208-209
[19] William Acton, MRCS, Functions and Disorders of the Reproductive Organs in Childhood, Youth, Adult Age, and Advanced Life, Seventh Edition, P. Blakiston, Son & Co., Philadelphia, 1888, pp. 208-209
[20] Dr. Bernard S. Talmey, “Sexual Hyperestheria in Women,” American Journal of Dermatology and Genito-Urinary Diseases, Vol. XI, January 1907, p. 164
[21] Dr. William J. Robinson, A Practical Treatise on the Causes, Symptoms, and Treatment of Sexual Impotence and Other Sexual Disorders in Women, Critic and Guide Company, New York, 1913, pp. 386-387
[22] The “restraint system” in French public asylums for the insane, The Lancet, 1865, p. 737
[23] Dr. William J. Robinson, A Practical Treatise on the Causes, Symptoms, and Treatment of Sexual Impotence and Other Sexual Disorders in Women, Critic and Guide Company, New York, 1913, p. 387
[24] “The Nervous Diseases of Women,” The Dublin Journal of Medical Science, April 27, 1883, p. 156
And a reminder that psychiatry and psychology (like virology) are just made-up professions based on nothing at all but opinion.
Roman this monstrous behaviour by the “medical” “profession” is difficult to read. Shining a light on it is sobering. How those armed with “first do no harm” could, even with the purest of motives condone such practices is hard to understand. You would think that anyone with a modicum of compassion and respect for the individual would have travelled down a different path.