Tag Archives: neurasthenia

Madness in a Modern World Part Two

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Crowded Train Platform in Victorian Era

Crowded Train Platform in Victorian Era

Life has always been stressful, so what was it about the nineteenth-century world that increased stress so much that alienists thought it contributed to a rising rate of madness (see last post)? Change itself brings stress, of course, and nineteenth-century humans were experiencing a great deal of change.

As telegraphs, telephones, locomotives, trolleys, and the like infiltrated daily living, it meant that the pace of life picked up for most people. Additionally, the noise level of society rose considerably as machines became more prevalent (even simple changes like clattering typewriters replacing writing by hand in offices). Studies show that constant noise increases levels of cortisol and adrenaline, which then have their own negative consequences on the body.

Interior of Magnolia Cotton Mills Spinning Room, Mississippi, circa 1912

Interior of Magnolia Cotton Mills Spinning Room, Mississippi, circa 1912, courtesy NARA

Not everyone embraced and trusted all the new inventions, either. Doctors diagnosed “elevator sickness” and “railway neurosis” brought on when people experienced the physical novelty and/or stress of using these new technologies. “Dyspepsia,” a term used to describe intestinal troubles of various kinds, was rampant in the nineteenth century–probably as a reaction to stress. Nervousness with life in general sometimes led to “neurasthenia,” a term encompassing feelings of anxiety, depression, irritability, and other symptoms of mental distress.

Noisy, Crowded Life in a New York Tenement, circa1890

Noisy, Crowded Life in a New York Tenement, circa1890

One of the positive beliefs alienists embraced was that insanity was not an inevitable hereditary condition, as had been previously believed. Instead, they began to believe that certain people were perhaps disposed toward insanity, but that it would only manifest if conditions were right. In the nineteenth century, it appeared that conditions were right for troubling symptoms to appear in many people.

 

The Rest Cure

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Dr. Silas Weir Mitchell

Dr. Silas Weir Mitchell

The rest cure was probably the most fashionable of responses to a condition of “nerves” or neurasthenia (see last three posts). Only the wealthy could afford such a complete withdrawal from obligations or work, let alone take on the obvious expenses of accommodations and treatment involved in the cure. Women took the treatment in disproportional numbers from men, but may have been kept out of asylums with its help. Even though some patients deplored this cure, surely it was better for both reputation and psyche than a stay in a madhouse.

Dr. S. Weir Mitchell was the leading authority on treatment through the rest cure, and was highly influential in popularizing it during the late 1800s. The rest cure worked in two ways: like a stay in an asylum, the rest cure took patients out of their homes and isolated them from whatever atmosphere, people, or situation had caused the problem; the cure secondarily worked on their body and mind by keeping patients at rest in a pleasant, cheerful environment.

Patients were literally forced to rest in a bed for six to eight weeks; massage and electrical stimulation helped keep their muscles toned during the enforced inactivity. Patients were washed by nurses, who also fed them a milk-based diet; milk alone might be given for the first week, or raw eggs if a patient couldn’t tolerate milk. Feeding was nearly continuous, and patients could be force-fed if they would not voluntarily down the quantities the staff tried to give them. Sometimes patients were not allowed to read, talk, or enjoy even the most minimally physical amusements. This probably separated the patient who merely wanted a change of pace or sanctioned escape from an unpleasant household situation from patients who truly needed care.

Patient Undergoing Rest Cure

Patient Undergoing Rest Cure

Dr. Mitchell at the Infirmary for Nervous Diseases, Philadelphia, 1902, courtesy National Library of Medicine

Dr. Mitchell at the Infirmary for Nervous Diseases, Philadelphia, 1902, courtesy National Library of Medicine

Insanity a Privileged Disease?

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The Surge in Nervous Diseases Created Interest in the Public

The Surge in Nervous Diseases Created Interest in the Public

Though insanity would never be welcomed by either victims or their families, it was perhaps a comfortable notion to think that it primarily afflicted “civilized” people and nations. Nervous diseases did not affect “savages.” Furthermore, the upper, leisured class could sometimes ascribe their whims, phobias, and “nerves” to their sensitivity and developed intellect, even when the conditions bordered on insanity.

Wealthy women could be dainty, frail, and too refined to bear anything sordid or “common.” They could afford to be highly strung, indulging in hysteria, moodiness, nervousness, and hypochondria.

Men shied away from hysteria, but they could manifest both hypochondria and melancholia without losing respect. People who had these nervous disorders, or neurasthenia, as coined by Dr. George Brown (see last two posts) could go to spas, travel, or take rest cures that might include bed rest, massage, and hearty meals. Sometimes for men, treatment would be vigorous outdoor exercise.

Victorian Woman Fainting of Neurasthenia

Victorian Woman Fainting of Neurasthenia

Though all these conditions caused distress and should not be considered false or amusing in any degree, only the leisured, wealthier class could manage to indulge in them without societal disapproval. A delicate blue-blood who could eat only the daintiest food was acceptable; a factory girl would be expected to eat what she was given.

A wealthy man could afford to be melancholic and withdraw from business or social obligations, whereas a working man would incur only anger or exasperation for the same behavior.

Finally, the wealthy could manifest these somewhat fashionable nervous conditions without acquiring the label of insanity or suffering the trauma of  commitment to an asylum. Because they had the means to help themselves in gentler ways via the advice and services of specialists, they could perhaps cope better with their condition so that it did not become worse, the way it might for a person in poverty and with no ability to get help at the onset of the problem.

Massaging Arm in the Rest Cure, circa 1890

Massaging Arm in the Rest Cure, circa 1890

Industrialization and Mental Illness

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George Beard

George Beard

Americans may have enjoyed many of the new inventions and opportunities the dawning industrial age offered, but many were also thrown off balance by the increasingly fast pace of the late 1800s.

Dr. George Beard noticed that Americans were having difficulty coping with life as new forms of transportation, communication, and automation made their way into society. He tried to make sense of the physical symptoms cropping up in far too many ordinary, upper and middle-class people, and determined that they were caused by an “exhaustion of the nervous system.” He termed the syndrome neurasthenia.

Beard's Book on American Mental Illness

Beard’s Book on American Mental Illnes

Though Beard’s observations were quite astute to some degree, he also perpetuated some stereotypes. He believed that “civilization” and its higher demands led to certain nervous conditions and physical complaints: “The savage can usually see well; myopia is a measure of civilization.”

Likewise, American women, who were given the opportunity to socialize more easily than women in other countries, developed their “cerebral activity” more quickly. This, in turn, influenced their physical development, with the end result that American women were typically more beautiful and expressive than women in other countries.

 

Americans Sought Help for Nervous Diseases

Americans Sought Help for Nervous Diseases

Pale Faces and Insanity

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A Klickitat Brave, 1899, couresty Library of Congress

A Klickitat Brave, 1899, courtesy Library of Congress

In 1906, Major Charles E. Woodruff, of the Army Medical Corps, wrote an article about nervous disorders and complexion. He believed that excessive exposure to light was responsible for much “nervous damage” to blonds, who didn’t have enough pigmentation to protect themselves in a sunny climate. Proof of this lay in the fact that neurasthenia was more prevalent in the South than in the North.

According to Woodruff, insanity probably followed the same rule. He asserted that “in every part of the world statistics show that the greatest number of cases occur in or near our lightest months–May, June, and July.”

Well-pigmented people, however, were much safer, and didn’t suffer from insanity to the same degree as the “less protected types.” He said that people with dark hair, brown eyes, and olive or brown skin, could “evidently stand mental and nervous strains which blonds cannot endure….”

Woodruff’s beliefs were in direct opposition to those who believed Indians had a high prevalence of insanity because of their exposure to civilization.

Hospital for the Insane of the Army and Navy and the District of Columbia, courtesy Library of Congress

Hospital for the Insane of the Army and Navy and the District of Columbia, courtesy Library of Congress

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