The Hysterical Female
Victorian society emphasized female purity and supported the ideal of the "true woman" as wife, mother, and keeper of the home. In Victorian society, the home was the basis of morality and a sanctuary free from the corruption of the city. As guardian of the home and family, women were believed to be more emotional, dependent, and gentle by nature. This perception of femininity led to the popular conclusion that women were more susceptible to disease and illness, and was a basis for the diagnosis of insanity in many female patients during the 19th century.
On the basis of Victorian gender distinctions, it was common for female patients to be diagnosed as suffering from hysteria. 19th century upper and middle class women were completely dependent on their husbands and fathers, and their lives revolved around their role as respectable daughter, housewife, and mother. With so little power, control, and independence, depression, anxiety, and stress were common among Victorian women struggling to cope with a static existence under the thumb of strict gender ideals and unyielding patriarchy.
Characterized by nervous, eccentric, and erratic behaviour, the epidemiology of hysteria eluded medical explanation in the Victorian era. Although there were hysterical males, attributing the condition to the female nature fit the social model of women, and validated the medical integrity of psychiatry by providing a suitable diagnosis. For hysterical women and their families, the asylum offered a convenient and socially acceptable excuse for inappropriate, and potentially scandalous behaviour. Rather than being viewed as a bad and immoral woman, honour and reputation could be maintained by the diagnosis of a medical condition and commitment to an asylum.
In contrast to the "true woman" was the "fallen woman," the term used to describe women - usually of the lower classes, and most commonly in reference to prostitutes - who had strayed from the cult of true womanhood by giving in to seduction and sin. The plight of the "fallen woman" was closely associated with the anonymity granted by the city, which left women vulnerable to temptation, alone and outside the protection of the home. The rise of the "fallen woman" intensified Victorians' already vigorous focus on morality, and gave rise to the moral reform movements of the 19th century. Asylums were viewed as a way to save these women, restore their respectability, and prepare them for a return to society in an acceptable female role.
As public institutions, asylums faced intense public scrutiny. This made superintendents very aware of the need to be progressive and innovative in the treatments used in asylums. Employing the latest technologies, trends, and theories of treatment was necessary for the success of the asylum in public opinion, and benefited the professional prominence of the superintendent. At the London Asylum, Dr. R. Maurice Bucke used controversial surgical procedures on LAI patients to establish himself as a leader in Canadian gynaecology. Bucke adopted the popular Victorian idea that the female reproductive organs were connected to emotional and physical well-being, and were thus the most likely cause of mental illness. Combined with the accepted theory that curing the body would cure the mind, treatments for female insanity at the London Asylum were grounded in the belief that removal or correction of the afflicted organ would restore sanity. Gynaecological surgery, such as hysterectomies became a regular procedure until the end of the nineteenth century, when advances in mental health care began to turn against it. Despite criticism that referred to his procedures as "meddlesome" and the "mutilation of helpless lunatics," Dr. Bucke continued the practice at the London Asylum until his death in 1902.
Using case studies from the LAI, Dr. Bucke presented his controversial theory and findings concerning the treatment benefits of surgery for female patients. He gave this speech (PDF file, requires Adobe Acrobat Reader to view) at the fifty-fourth Annual Meeting of the American Medico-Psychological Association, held in St. Louis, 10-13 May 1898. (The New Consciousness: Selected Papers of Richard Maurice Bucke, compiled by Cyril Greenland and John Robert Colombo. Toronto: Colombo and Company, 1997.)