Culture of Illness
Early in the nineteenth century, German physician Theodore L.W. Bischof performed a revolutionary experiment on his female dog. Over the course of several surgeries, he discovered that “the ripening and expulsion of the egg during heat [occurred] independently of coition” (Laqueur 26). Here was empirical proof that the cycles of egg production were regulated internally, rather than, as physicians had assumed, propelled by heterosexual intercourse. While this discovery is hardly surprising to twentieth century readers, the implications for Victorians were tremendous. Below, I describe how this discovery and other medical theories were used to articulate guidelines for women’s domestic responsibilities and bolster claims about their intellectual limitations, giving weight to the widespread belief that women were at the mercy of their bodies and required a tranquil, domestic existence. However, despite their presumed physical limitations, women of all classes were still expected to fulfill their social, domestic, and economic responsibilities; there was a plethora of information instructing women on how to manage their bodies while meeting the responsibilities that kept their families intact and the economy churning smoothly. What developed was a culture of illness in which the ideal woman was portrayed as practically competent and physically ill: both functional and dysfunctional.
Once Bischof proved that ovaries were naturally self-governing, the intellectual leap from female dog to female humans was quick and efficient. As Thomas Laqueur points out in “Orgasm, Generation, and the Politics of the Reproductive Biology,” the leap was summarized by American physician Augustus Gardner: “The bitch in heat has the genitals tumified and ruddened, and a bloody discharge. The human female has nearly the same” (26). An 1843 article in the Lancet similarly announced that “the menstrual period in women bears a strict physiological resemblance to the heat of brutes” (Laqueur 27). But nineteenth century science went further to argue that menstruating women were always experiencing some aspect of ceaseless and powerful ovarian functions. They were constantly at the mercy of their bodies. The discovery of spontaneous ovulation helped reduce “women to the organ that differentiate[d] them from men” and rendered them permanently, perpetually unstable (29).
Victorian medical theories saw the female reproductive system as a volatile exchange of energy and fluids requiring an outlet for release and subsequent replenishment. Of course, conception and childbirth provided the exact release necessary to maintain this delicate balance. Without release, the danger of undue energy accumulation loomed. Mary Poovey summarizes Victorian physician Thomas Laycock’s assessment of the female reproductive system as a “unified, self-regulating system subject to constant internal variation, the slightest irritation of any part of the system is liable to upset the balance. The likelihood of disorder is further enhanced by the greater delicacy and sensitivity thought to characterize female nerves” (Poovey 146). On this model, women had a propensity toward imbalance at best and insanity at worst. While Victorian psychiatry had “vague and uncertain,” concepts of mental illness, it seized on the new biology of female reproduction to link women’s psychological disturbances “specifically and confidently to the biological crises of the female life-cycle—puberty, pregnancy, childbirth, menopause—during which the mind would be weakened” (Showalter 55).
As the century progressed, science gathered more evidence for the female disposition toward disease and psychiatry’s confidence grew. “Thus the second generation of nineteenth-century psychiatrists, inspired by Darwinian theories of evolution geology, biology, and the social sciences, sought to apply rigorous scientific methods to the study of insanity [and] they insisted that insanity had a physical cause that could be discovered by a sophisticated medical practice” (Showalter 104). As Showalter explains in The Female Malady:
Theories of biological sexual difference generated by Darwin and his disciples gave full weight of scientific confirmation to narrow Victorian ideals of femininity. Female intellectual inferiority could be understood as the result of reproductive specialization, and the ‘womanly’ traits of self-sacrifice and service so convenient for the comfort of a patriarchal society could be defended in evolutionary terms as essential for the survival and improvement of the race. (122)
Alas for the Victorian woman—her naturally flawed, overwrought reproductive system, which could be upset by the slightest physical or emotional strain—was the command center for her entire body. She lived in a “normal” state of physical and mental instability. In “Female Circulation: Medical Discourse and Popular Advertising in the Mid-Victorian Era,” Sally Shuttleworth describes how reproductive cycles set the stage for a woman’s entire life. Ovulation and menstruation were thought to play
a uniquely causative role in the unified circulating system of body and mind. The
physiological, mental, and emotional economies of womanhood were all regarded
as interdependent. Any aberration in menstrual flow . . . must inevitably create an
equivalent form of mental disorder. Similarly, strong emotions could cause
menstrual obstructions leading in turn to insanity and death. (47)
What was a Victorian woman to do, if, as Vandereycken and van Deth describe, “with the uncontrollable monthly bleedings, the deeply rooted ‘animal nature’ in every woman threatened to break out, a monthly time bomb to every middle-class family, which was founded on the Victorian values of control, discipline and rationality” (198)? The Victorian woman existed in a constant state of dilemma, subject to the commands of “recurrent cycles of rut,” and also required to “transcend the brutish state” and serve as loving wife, mother—bastion of hearth and heart (Laqueur 127-8). Fortunately, numerous magazines and pamphlets detailed the physical and behavioral regimes necessary for health and sanity. Despite the contemporary perception of Victorian women as “blind” to their bodies they were actually immersed in the medicinal discourse of their bodies: “We must discard our customary image of Victorian middle-class women as isolated from physical contact and understanding of their own bodies, and in its place substitute a (perhaps slightly even more disturbing picture) of women anxiously monitoring the slightest aspect of their bodily functions” (Shuttleworth 48).
While the new sciences of female reproduction and psychiatry were initially offered to a professional audience, messages about the volatile female body and its subsequent limitations were spread through the culture. In a study of two British newspapers, The Leeds Intelligence and The Leeds Mercury, (from 1830-1855), Shuttleworth found that they featured a plethora of advertisements and articles geared towards female health. The “advertisements directed specifically at a female audience were distinguished by lengthy preambles and ‘medical’ justifications that reiterated and confirmed contemporary beliefs in the peculiar delicacy of the female system and the pernicious impact of menstruation” (49). Popular messages also linked a woman’s overall state of health to a successful family life. A home health guide from the era told its female readers that a wife’s balance and well-being was essential to creating a home that was “a place of repose, of peace, of cheerfulness” (Ehrenreich and English 107). Maintaining her health and monitoring her family’s meant a woman needed to buffer herself from exertion—physical, emotional, or intellectual—that might disrupt the menstrual cycle, her tenacious grip on health, and her smooth family life. “Woman’s ‘mission’ is to try and suppress all mental life so that the self-regulating processes of her animal economy can proceed in peace. Female thought and passion . . . created blockages and interference, throwing the whole organism into a state of disease” (Shuttleworth 59).
Naturally, Victorian women were sick. The vagaries of their illnesses helped create a social environment in which food refusal and restrictive eating habits flourished. The most common “nervous” diseases disrupting and defining the lives of Victorians were melancholia, hypochondria, hysteria, neurasthenia, and dyspepsia. With their emphasis on appetite and digestion, hysteria, neurasthenia, and dyspepsia were particularly important in setting the stage for anorexia nervosa. Now infamous, hysteria was so commonly diagnosed in Victorian women that it came to play “a peculiarly central role in psychiatric discourse, and in definitions of femininity and female sexuality” between 1870 and the late 1930s (Showalter 129). Hysteria had a dizzying array of symptoms: choking, fainting, heart palpitations, paralysis, blindness, impaired hearing, convulsions, seizures, or extreme emotionality, to list a few. The hysterical lack of appetite was commonplace; as early as the seventeenth century, disturbed appetite was identified as a standard symptom of the disease.[i] For the Victorian physician the hysteric was hardly the discursive material that she is today: she was materiality itself, scientific discovery and fact. Her ailment had biological origins and “nineteenth-century physicians took pains to legitimate hysteria as a real illness . . . especially biological in origin (Vandereycken and van Deth 201).
Closely related to hysteria, neurasthenia was a more prestigious type of nervousness that struck men as frequently as women and was traced to the stresses of technology, speed, and urban life.[ii] First described by American neurologist George M. Beard in 1869, neurasthenia’s symptoms included dyspepsia, insomnia, headache, fatigue, dyspepsia, flushing, drowsiness, bad dreams, dilated pupils, mental irritability, abnormal dryness of the skin, joints and mucous membranes, desire for stimulants and narcotics, hopelessness, deficient thirst, pains in the back, shooting pains, cold hands and feet, a feeling of profound exhaustion, difficulty swallowing, obsessions, itches and the list goes on (Gosling 14). From this list, digestive troubles stood as among the most consistent and troubling symptoms of neurasthenia. While dyspepsia was one of neurasthenia’s symptoms, it also stood alone as a distinct disease that had, according to Schwartz, enjoyed the status of “The American Disease” for several decades until displaced by neurasthenia (47). For Americans seeking thinness and buoyancy, dyspepsia was of “such concern because it was marked by chronic sensations of heaviness and sinking, sensations focused on the stomach and associated with gluttony” (47). The disease also struck the more delicate interiors of the well-educated middle-class; it appeared that the “laboring poor seemed to have truer appetites and stronger digestions than students (especially female students), ‘literary men, officers of state, dealers in scrip, daring adventurers, and anxious and ambitious projectors of improvement’ “(70). Brumberg describes the dyspeptic woman as having “no particular organic problem; her stomach was simply so sensitive that it precluded normal eating” (173). Dyspeptics embarked upon vigilant food regimes and carefully documented all their various intestinal torments until they settled upon a selection of foods they could tolerate in small amounts. They eventually learned to survive on very little food.
In sum, the second half of the nineteenth century saw a “general female fashion for sickness and debility . . . and a “wide spectrum of picky eating and food refusal ranging from the normative to the pathological” (Brumberg 171). The eating practices of adolescent girls received an unusual amount of scrutiny because appetite, “as a barometer of sexuality,” was carefully controlled (Brumberg 174). Although today appetite, eating, and food are powerful metaphors for female sexuality and desire, for Victorians they were not merely metaphors but actual measures of sexuality. Female digestive processes were related to reproductive organs because, as Schwartz quips, “folklore and popular medicine made a single bundle of tissue and fluid out of a woman’s innards. . . . Any diet women undertook had at once a digestive and reproductive meaning” (51). Considering the vaguely ill condition of the female body, and diminished appetite as symptom of disease and barometer of sexuality, it’s not too surprising that “young women presented unusual eating and diminished appetite more often than any other group in the population” (Brumberg 174). During this era of nervous digestion anorexia was first identified as a distinct disease. For all the delicate eaters that physicians saw—and expected—there were an increasing number of girls and young women who stood out for their utter refusal to eat at all.
[i] See Vandereycken and van Deth for a history of hysteria with an emphasis on lack of appetite, 125-131.
[ii] Vandereycken and van Deth liken twentieth-century stress to nineteenth-century neurasthenia, pointing to contemporary stress-related diagnoses and the increasing emphasis (both among laypeople and within medicine) on connections between stress and disease. Victorians were neurasthenics, and we’re stressed.