by Philipp Blom
Nonetheless, the dimensions of the problem were frightening. In Germany, 40,375 patients were registered in mental hospitals in 1870. The number rose to 115,882 in 1900 and 220,881 in 1910. Over the same period, the proportion of patients admitted to general hospitals for ‘illnesses of the nervous system’ rose from 44 to 60 per cent. While these numbers include those suffering from many and varied mental conditions, not just neurasthenia, they do not include the huge number of sufferers who preferred going for cures or long stays in private sanatoriums, spas or other paramedical establishments in which a doctor would look after the guests - as in the one described by Thomas Mann in The Magic Mountain. Nor do they include those neurasthenics who simply consulted a doctor. There is, however, one more interesting number to report. While hysterics were overwhelmingly female, some 68 per cent of neurasthenics were (according to the figures of one specialized institution at least) men.
Was neurasthenia an illness of successful middle-class men? Of course it was not as simple as that. But workers who were institutionalized for ‘shattered nerves’ usually complained about the pressure of piecework and the noise and danger of the large machines they operated, while a large proportion of the women treated broke down under the strain of working, studying and trying to win a place in the world. These are conditions that today’s doctors would diagnose as different from the feelings of inadequacy and the battles with their sexual selves that were related by the overwhelming majority of male patients from the worlds of business, academia or government. Neurasthenia was a condition that illuminated the emotional constellations of its time.
Sex, Lies, and Early Cinema
Over the past decades, research into the history of women has revealed a dimension of historical reality that had long been neglected. The high incidence of nervous diseases among men, however, shows that the turn of the century was also a difficult time in which to be a man. Squeezed between what many saw as the relentless demands to perform and the changing role of women, male identities were under threat. It is therefore not surprising that the anxieties expressed by neurasthenics almost always had a sexual component.
Sex had become more available. At the same time it had become a problem, a threat. Expectations and opportunities had changed, particularly in the cities, and particularly among the young. Cheaper coal for heating and functional apartments meant that there was more privacy. The younger members of a household were now more likely to have a bed or even a room of their own. Students often lived in rented digs. Technology and science also fostered a different relationship to the outside world, and to sexuality. Freud’s theses on the omnipresence of sexuality had found their way into polite drawing rooms (not in front of the servants, of course), and publications linking sexuality and ‘natural’ or ‘primitive’ environments flourished, as is shown by the runaway success of popular science books like Wilhelm Bölsche’s Das Liebesleben in der Natur (Love-Life in Nature, 1898-1902) or the many, sensitive and sensible sexological treatises by the British doctor Havelock Ellis.
The city itself presented a multitude of temptations and erotic possibilities among the anonymous crowd, and with it a host of perils, real and imagined. Boulevards attracted night birds, and inns offered easy and inebriated acquaintances; theatres, cinemas and revues excited their audiences by showing as much flesh as possible; pornographic photographs were sold on street corners (as well as through newspapers by mail order); stag films were shown during all-male celebrations and there was a large enough intake of young, single and usually poor women to ensure an unlimited supply of prostitutes. Unmarried men were tacitly expected to seek their pleasure in this milieu, as long as they settled down by the time they married.
At the same time, sex was danger. Many neurasthenics thought about their illness as the ‘consequence of their youthful follies’ - an unmistakable allusion to syphilis and to the allegedly devastating effects of masturbation. The fear of a steady descent into madness and a slow, agonizing death through syphilis was a constant presence in the West, and even a moderately hypochondriac disposition could be enough to make a mature adult who had ‘seen the world’ terrified at the slightest symptom that might be an indication of this cruel souvenir of early ardour.
‘Manliness,’ wrote Ernest Monin in 1890, ‘very probably originates from the incessant reabsorption of sperm [into the blood] ... The abuses of coitus or of masturbation, the loss of sperm, etc., bring on a depletion of seminal secretions, and with it neurasthenia, phobias, etc.’ Sexual activity, especially activity not destined for procreation, resulted in an inevitable decline and degeneration of the enfeebled individual. Even Sigmund Freud believed that the neuralgic pains he suffered from were the result of ‘incomplete intercourse’ with his wife, and doctors everywhere gave parents serious advice on how to prevent their children from masturbating, ranging from avoiding licentious remarks and spicy foods to having cold showers, injections, and even cauterizing the genitalia of girls - all in a good cause.
The world had grown more exciting, the pervasive capitalist ethic invited people more strongly than before to be masters of their own lives, to work hard and play hard and to decide who and what they wanted to be, but it was almost universally agreed that giving in to this excitement would have the gravest consequences. While ‘manliness’ was a cardinal virtue, sex was still a mortal sin. ‘The bed is the real battlefield of the neurasthenic,’ one German patient remarked.
The transformation of the role of women was an added stress to men and their identities. Now that suffragettes were demonstrating for their rights and more women were gaining a measure of independence by earning their own money and going to university, men, it seemed, had to be stronger, more manly than before. Confronted with this cocktail of constant energy, temptation, demonized sexuality and a new, strong kind of woman, male feelings of inadequacy were inevitable. ‘Every female creature,’ wrote a twenty-year-old German student to his father from a mental institution, ‘is a dagger in my heart: you are abnormal, you are abnormal! You cannot have intercourse! You are a perverse sadist!’
For medicine, neurasthenia also had a very gratifying characteristic: as an illness, it was vague enough to become a canvas on which to paint many a picture of society’s preoccupations. In Russia, psychological research was very advanced and active, and many researchers found themselves intrigued by the illness, before becoming disillusioned with the terminological ragbag in their hands. Beyond the medical establishment, the ‘civilization disease’ elicited very different responses. To those wishing to Westernize the empire, it was an essential part of modernity and therefore almost a welcome sign: ‘At present we Russians will hardly find rivals in other nations when it comes to the enormous number of neurasthenics in our homeland. Might one therefore not be justified in calling neurasthenia the Russian illness?’ asked Pavel Kovalevskii, himself certainly no modernizer. His own answer was damning: ‘Lacking God within them, [the Russian people] rushed to embrace Mammon…The pursuit of profit required extreme exertion of energy and effort: countless sleepless nights, excessive mental exertion, lack of means, frequent bargaining with one’s conscience - this could not help but devastate the nervous system.’
Civilization in the image of Paris and London had created unRussian creatures without morals, urban degenerates, who were, according to the writer Sergei Aksakov, guilty of ‘contemptuous lack of faith in one’s own strength, firmness of will and purity of intentions - this epidemic of our age, this black impotence of the spirit that is alien to the healthy nature of the Russian, but that is visited upon us for our sins’. The perceived impotence of the nation was as much of a threat to Mother Russia as literal impotence was to many individual sufferers, and it was a threat that came from the cities: ‘In Petersburg there is no sun,’ commented Kovalevskii in 1903.
You could charge admission for showing the Petersburg sun, it’s such a rarity. In Petersburg there is no air. In Petersburg there is no light, no space, no life ... There is only vegetative existe
nce. People have turned day into night and night into day ... In Petersburg people work beyond their strength, but they blabber even more ... Given such a life, can we really expect health, the continuation of our race, the strengthening of society? ... Never - degeneration is its fate.
In different terms, this debate was mirrored in the very country that the believers in Holy Russia were most disgusted by: in France. If in the Tsar’s empire the idea of neurasthenia conjured up the eternal debate between Slavophiles and Westernizers, in France the ideas of speed and nervousness elicited not only the enthusiasm of Apollinaire and the patient art of the self-confessed neurasthenic Proust (whose father was a doctor who had published on the illness), it also summoned the spectre of national decline and infertility. Many of the motifs of this debate belong in the context of the Dreyfus trial and the concerns about sinking birth rates, but neurasthenia reinforced and focused them. A few young artists and metropolitans might be having fun with fast cars, but for others the speed of the age was a sign of degeneracy and moral failing. Writing in 1901, Louis Bally delivered an angry attack on ‘a generation of playboys and pleasure-seekers, anaemic and neurasthenic, bereft of both will and courage ... the impotent and the tubercular, who lie about…in café concerts and fashionable brasseries’. Neurasthenia, which was as endemic in France as it was in Germany, was seen predominantly as a moral failing, induced by the ‘unhealthy’ life of the cities. ‘No wonder our boys are becoming neurasthenics,’ commented an outraged Virgil Borel, because all conditions conspired to ‘annihilate individual initiative, force of will, moral energy and firmness of character’.
Like their avant-garde counterparts who saw speed and energy as erotic forces, they were mainly preoccupied with sex. Neurasthenia was a matter of modern egoism, of men seeking pleasure in the fever swamp of the capital instead of devoting themselves to the nation. Already the school books told children that illness was evidence of moral weakness. ‘It is necessary to resist [illness], be strong and the disease will not vanquish us. But if we are not strong, it is our own fault. We deliver ourselves up to our vices and they kill us.’ Syphilis was a direct consequence of moral degeneracy, and nervous exhaustion was often held to be the same: men who were too ‘selfish’ to settle down and have plenty of children and preferred to ‘waste themselves’ by indulging in pleasures of the flesh. Men who, like masturbators, were ‘squandering their seed’ wound up exhausted, wrecked, and spent.
In Austria-Hungary the disorientation was viewed with interest, rather than fear. The reason for this may lie partly in the fact that in the more rural, less industrialized Habsburg empire, neurasthenia was experienced by a smaller circle of people, mainly among the middle classes of cities like Vienna, Prague, Budapest and Lemberg. The condition was even intensified by the constant rivalry between ethnic groups and the fragility of social identities.
Schiele’s portraits, Klimt’s disquieting sensuality, the social and erotic entanglements of Arthur Schnitzler’s stage characters are all shaded by neurasthenia, and Gustav Mahler’s life reads like a case study: from his search for erotic fulfilment in the arms of his young wife Alma (he was not a good lover, she would later state) to his obsessive work schedule, his humble background and lack of confidence, his nervous crises and his need for solitude. He even consulted Sigmund Freud about his problems, and the doctor met him in Leiden, in the Netherlands - a great compliment to the composer, as Freud usually refused to treat mere neurasthenics, thinking there was nothing hidden to be discovered in their dreams and fantasies, which bored him. Mahler’s grand symphonic gestures, ranging from the morbidly introspective to the maniacally grandiose, are musical illustrations of the condition: the constant intrusions of the outside world (the military band, the banality of dance music puncturing the delicate mood in the scherzo of the First Symphony, for instance), the mechanical rushes, the occasional sentimentality, the constant, undercutting irony and the overwhelming longing for transcendence and for peace, are expressed in texts of childlike simplicity.
There was a pervasive sense in Austria-Hungary that neurasthenia was culture (witness Freud’s fondness for literary and mythological examples) and it is not surprising that the most vociferous and vituperative conservative critic of his time, the Zionist Max Nordau, inverted this equation. To him, contemporary culture was itself a symptom of disease and degeneration. The physician, he wrote, ‘recognizes at a glance in the fin-de-siècle disposition, in the tendencies of contemporary art and poetry, in the conduct of men who write mystic, symbolic and “decadent” works, and the attitude taken by their admirers and aesthetic instincts of fashionable society, the confluence of two well-defined conditions of disease ... degeneration and hysteria, of which the minor stages are designated as hysteria.’ Culture itself was diseased by an excess of sophistication and urban life. ‘The inhabitant of a large town ... is continually exposed to unfavourable influences which diminish his vital powers,’ he wrote.
Habsburg art, then, was positively flamboyant in its often fascinated investigation of neurasthenia and its psychological dimensions. In Britain’s medical establishment, the response to neurasthenia was mainly a stiff-upper-lipped disapproval of histrionics. Not that anyone doubted its existence, as one of the most famous practitioners, Sir Thomas Clifford Allbutt (who also held the wonderful title of Commissioner for Lunacy), noted: ‘not only do we hear, but daily we see neurotics, neurasthenics, hysterics, and the like: is not every large city filled with nerve-specialists, and their chambers with patients.’
‘Neurotics, neurasthenics, hysterics, and the like’ had become part of the medical landscape. Extensive theorizing about the condition, however, was left to Continentals. Allbutt himself was certainly not interested in elevating sufferers to the status of brain-working, fast-living modern antiheroes. Neurasthenia, he wrote, ‘is common enough also in the wage-earning classes of England; it is frequent in West Riding, especially, I think, among colliers ... The truth is that neurasthenia is found no more in the marketplace than in the rectory or in the workhouse; no more in busy citizens than in idle damsels.’ While degeneration of national strength was a concern as everywhere else, there was little or no indulgence of foreign fancies. Some people were simply nervous; their complaint would be made worse by overextension, and better by cool baths, rest cures, sexual abstinence, healthy activity like riding, entomology or apiculture, and a little dose of blood-enriching arsenic.
This expert dismissal, however, did not lessen public concern. Popular newspapers were full of advertisements for nerve tonics and health resorts. Much stronger than in the official debate, the old concerns about sexual exhaustion and general inadequacy resurface in these texts. Beechams Pills, Tidman’s Sea Salt, Ambrecht’s Coca Wine and Odo-Magnetic Apparel - hundreds of products were advertised for the treatment of ‘nervous exhaustion and enfeebled constitution’.
Germany and Nervous Tension
If neurasthenia was the illness of the age it also quickly became a way of life for modern men like the Kaiser. Like no monarch before him, ‘William the Traveller’ or ‘William the Sudden’ as his entourage called him behind his back, had embraced technology, speed and the media; like millions of his subjects, he too suffered from the vertigo brought on by this fast ride.
Notorious for his explosiveness, irritability and short attention span, the Kaiser exasperated those around him. ‘He always wanted something to happen, always wanted new impressions, new images,’ recounted the erstwhile Reich chancellor, Bernhard Fürst von Bülow. The monarch found it simply impossible to stand still; rather, he raced through his life like someone ‘who is driving downhill too fast and has difficulties controlling his vehicle’, wrote the diplomat Friedrich August von Holstein to Prince Eulenburg, who replied: ‘the poor Kaiser makes everyone nervous, but that can no longer be changed.’ The Protestant theologian Friedrich Naumann had an interpretation that was at once more positive and more general: ‘Wilhelm II is the first virtuoso of the modern traffic age. He participates
in life everywhere, listening by telegraph and talking at the same time,’ he wrote in 1905, concluding: ‘he is an incarnation of the electrical tendencies at work in all of us.’
The Kaiser loved speed and was always in a rush. When he was late for the funeral of Queen Victoria in 1901, he ordered the train driver in Portsmouth to stoke the locomotive with every ounce of coal on board, and he did, pushing the engine to 145 kilometres per hour, an unheard-of speed which almost sent the imperial party hurtling off the rails. Throughout his reign, Wilhelm kept up a constant and prodigious travel schedule. In an average year, he would not spend more than four months in Berlin. It is hardly surprising that a veiled satire on the Kaiser, Ludwig Quedde’s 1894 novel Caligula (which quickly went through 34 editions), describes the Roman Emperor ‘hurrying endlessly from one task to the next, caught in nervous haste’. Like his fictitious counterpart, the German Emperor would get excited about an idea and then try to push it through come what may, never more so than when they gave him an opportunity to show strength, modernity, might. ‘Never has a temptation excited the Kaiser’s nerves as much as the fleet project,’ noted Holstein.
Speed and energy - not always well directed - were declared the watch-words of the day. So universal was the feeling of pressure that the respected and conservative paper Deutsche Rundschau could run a story about a high-school boy who had contracted a fatal meningitis from learning the gerundive of the Latin verb amare (to love). One has to admire the journalist for finding a story that included all ingredients: the rigidity of society represented by the school, the pressure of having to work hard in order to get on, and the devastating confusion resulting from any confrontation with sex - even or especially in the gerundive.