Mad, Bad, and Sad: A History of Women and the Mind Doctors

by Lisa Appignanesi

  What Cheyne and his like helped to produce was a time which, as Roy Porter has argued, grew more sympathetic to madness and oddities of mood and behaviour. Even if many of Cheyne’s quoted cases of distemper–and he provides eighteen histories plus his own far longer and more detailed one–are arguably at the milder end of the ‘madness’ spectrum, their fashionable prevalence, together with his insistence on the good character and often high birth of his patients, made even more extreme states seem less threatening. The ‘vapours’, various forms of derangement, could come and go like so many cycles of the moon, which had kindly lent its name to the state of ‘lunacy’.

  By the time Mary Lamb murdered her mother and wounded her father, this sympathy was in full play and married to a Romantic sensibility open to greater extremes of behaviour. The climate, however, was soon to shift and we see this through the course of Mary’s own lifetime. The very ideas surrounding madness which were to allow her a life within society–that is, its periodic nature; its invisibility within periods of sanity–were increasingly to combine with the growing profession of mind doctors, or alienists, to transform her and her kin into ‘dangerous individuals’. Such newly invented types could erupt into ‘homicidal mania’, which was what the ‘dangerous frenzy’ attributed to Mary became–its very invisibility and unpredictability determining that danger.

  But to say that such catalogued, categorizable and confined individuals were the creation of state powers working in some kind of collusion with the courts and a nascent psychiatric profession in Britain–as Michel Foucault, the great French historian and philosopher, claims for France and tangentially the rest of Europe–would be wrong. It is not quite accurate–and not only because of the laissez-faire nature of the state and the liberal economy in confinement which allowed both state and private care, and prevailed until mid-century in Britain. What Mary’s case shows us is that she and her brother, along with their peers, the literature and modes of life they championed, the new understanding of childhood they put into play with its impact on the nature of remembering and imagination, its quest for sensitivity and feeling, also turned the desired new individual into one in whom the invisible inner life was a priority and its remarkable nature something of an asset. Multiple forces played on and into each other to create this new being who sometimes preferred to be the exceptional case the doctors diagnosed.

  This did not happen all at once.

  MADNESS AND EVERYDAY LIFE

  Returned to reasonableness some six weeks after the events, Mary stayed on in the Islington madhouse, in part because her elder brother John wanted her to be kept in confinement, in part because Charles could not keep her at home while their senile father–who had witnessed the terrible events and was afraid of his daughter–was still alive. By April of 1797, however, Charles had moved her into lodgings of her own, as his letter to Coleridge explains:

  I have taken her out of her confinement, and taken a room for her at Hackney, and spend my Sundays, holiday, etc, with her. She boards herself. In one little half year’s illness, and in such an illness of such a nature and of such consequences! to get her out into the world again, with a prospect of her never being so ill again–this is to be ranked not among the common blessings of Providence…Congratulate me on an ever-present and never-alienable friend like her. [7 April 1797]

  Mary may have remained Charles’s ‘never-alienable’ friend. She may never again have been ill enough to commit murder. But she suffered from recurrences of her condition almost annually, sometimes more frequently.

  In April 1799, after the death of their father, brother and sister set up house together, first in Chapel Street in Pentonville. Some return of Mary’s madness, or perhaps simply the suspicion of neighbours which distressed her and might have exacerbated her condition, forced a move to Holborn and then for some years back to the childhood haunts of the Temple, which they both adored. ‘It is a great object to me to live in town,’ Charles wrote in a letter of 20 May 1800 to Thomas Manning, ‘where we shall be much more private; and to quit a house and a neighbourhood where poor Mary’s disorder, so frequently recurring, has made us a sort of marked people. We can be no where private except in the midst of London.’

  The bustling city, with its anonymous crowds and rampant eccentricities, seemed more conducive to ordinary life than the quiet of village or countryside. When she was well, Mary helped Charles with his writing, did her own–including all the comedies in their Tales from Shakespeare–kept house for him, entertained. From what we know, fatigue, overexcitement, occasioned by a run of visitors or travel, the report of deaths, or something to remind her of her mother, all singly or together, might spark a new bout of illness. At each bout, in the early years, Charles brought her to one of the Hoxton madhouses. Mary and Charles both learned to recognize the gathering symptoms. They took pre-emptive action. As did Coleridge. Staying with them in late March and April 1803, he writes to his wife Sara:

  I had purposed not to speak of Mary Lamb–but I had better write it than tell it. The Thursday before last she met at Rickman’s a Mr Babb [or Babbs?], an old friend and admirer of her mother.

  The next day she smiled in an ominous way–on Sunday she told her brother that she was getting bad, with great agony–on Tuesday morning she layed hold of me with violent agitation, and talked wildly about George Dyer [a friend of the Lambs]./I told Charles, there was not a moment to lose/and I did not lose a moment–but went for a Hackney Coach, and took her to the private Madhouse at Hogsden/She was quite calm, and said–it was the best to do so–but she wept bitterly two or three times, yet all in a calm way. Charles is cut to the heart. [4 April 1803]

  In this description, Mary is resigned to her need to be confined until the ‘violent agitation’, which often also expressed itself in a rush of language, a galloping imagination uncontrolled by judgement, subsides. Friends talk of the poignant spectacle of brother and sister walking hand in hand to the madhouse carrying a straitjacket between them, the tears rolling down their faces.

  Brother and sister were deeply upset both by Mary’s ‘breakdowns’ and by the difficulty of emerging from them. ‘I strive against low spirits all I can, but it is a very hard thing to get the better of,’ she writes to Dorothy Wordsworth on 9 July 1803. Charles often fell into ‘low spirits’ too, sometimes in tandem with his sister’s explosions: one might speculate that they set each other off, though it is difficult to know who lit the spark on any given occasion.

  Melancholy was a ‘fashionable’ condition for Georgians of sensibility. For a condition to be fashionable means that its symptoms are known to many and in some sense aspired to. To put it the other way round, the malaise of everyday life, unhappiness, suffering, can be cast into the shape of the ‘fashionable’ disease. Others, including doctors, recognize its existence. Recognition can help the unconscious shoe-horning of free-floating symptoms into the given shape. A little like Pascal’s wager–in which to live the rituals which attend the possible existence of God eventually makes of one a believer–the wearer of that particular condition’s shoes may eventually find the fit so perfect, the shoes no longer come off. Amongst many others, James Boswell (1740–95), Samuel Johnson’s biographer, suffered from melancholy, and did so flamboyantly. He gave the column he wrote in The London Magazine (to which Lamb also later contributed) the title ‘Hypochondriacus’, reflecting one of the period’s alternative names for that mixture of lethargic low spirits, mood swings and unplaceable and misplaced fears and anxieties that make up melancholy. But the lability of imagination and temperament in which Boswell indulged, Johnson warned him–and he knew from his own experience–was always shadowed by the possibility that it would topple into uncontrolled madness. There are some suggestions that Boswell’s playing with melancholy, enacting its tropes, did finally topple his hold and sped the collapse of his last years. The fact that any of this can be observed rarely means that it is willed or wilful.

  Around 1800, when Coleridge asked Charles Lamb to wri
te a pastiche of Burton’s Melancholy, Charles also produced the poem ‘Hypochondriacus’. This galloping doggerel enacts the fashionable, tolerable sides of melancholy. It spoofs them. At the same time, it is redolent of the threat that melancholy with its persecutory sides poses.

  Black thoughts continually

  Crowding my privacy;

  They come unbidden,

  Like foes at a wedding,

  Thrusting their faces

  In better guests’ places,

  …

  In my ears whispering,

  ‘Thy friends are treacherous,

  ‘Thy foes are dangerous,

  ‘Thy dreams ominous.’

  It is tempting to think of Charles and Mary Lamb as living out the two possibilities that madness in Georgian England presented. Charles, the melancholic; Mary, the passionate revolutionary, who explodes to kill off the oppressive elders and is perpetually burdened by the fear that violence will return. The later essays Charles wrote in the person of Elia, with their digressive flow of free and imaginative association–an outpouring which mirrors self-confession, always slipping out of control and being ushered humorously back into its confines–are the apogee of early Romantic sensibility. Mary lives out the darker side, where judgement goes awry, control is lost, and the ‘perturbed conversation’ which signals and accompanies mania returns almost annually ‘in the most wretched desponding way conceivable’.

  Charles’s continuing and assiduous care of her feels like part of a devil’s bargain. There can be no partner other than Mary, since she enacts what he fears most and drinks increasingly to escape. On her side, one senses, she is so grateful to him, she has to escape his presence via the only route she increasingly knows: madness. And though she talks of the madhouse as her ‘banishment’, she keeps the straitjacket by her side, packs it on travels, and goes willingly to the nearest asylum when she feels her condition coming on.

  In one of her rare letters about the condition, Mary writes to her friend Sarah Stoddart about her mother, who has ‘gone out of her mind’:

  …do not I conjure you let her unhappy malady afflict you too deeply–I speak from experience and from the opportunity I have had of much observation in such cases that insane people in the fancy’s they take into their heads do not feel as one in a sane state of mind does under the real evil of poverty the perception of having done wrong or any such thing that runs in their heads.

  Think as little as you can, and let your whole care be to be certain that she is treated with tenderness. I lay a stress upon this, because it is a thing of which people in her state are uncommonly susceptible, and which hardly any one is at all aware of, a hired nurse never, even though in all other respects they are good kind of people. [November 1805]

  The insane cannot be held accountable for the fancies that leap into their heads: nor should their near ones take these to heart. But tenderness is important. In fact, kind treatment is everything.

  It is unclear whether Charles, for all his lifelong loyalty (and who would blame him!), always provided tenderness: there are reports of teasing behaviour which many, and even Mary herself, sometimes found insulting, certainly discomfiting. Then there was his alcoholism, which worried Mary and which she attempted, with little success, to control. Then, too, there was Charles’s inability either to get on with his writing or to finish projects he had started.

  But Charles cared for his sister to the point of misery–certainly giving up any realistic hope of a married life that might exclude her. In a letter to Dorothy Wordsworth, written just after Mary has been confined, he notes: ‘when she begins to discover symptoms of approaching illness, it is not easy to say what is best to do. Being by ourselves is bad, and going out is bad. I get so irritable and wretched with fear, that I constantly hasten on the disorder. You cannot conceive the misery of such a foresight’ (16 June 1805).

  The guilt Charles expresses in letters to friends is a perennial aspect of this cycle of illness and care, in which his depressions or passions provoke hers, and round again, until in one sense the spectre of insanity encompasses them both. As Mary’s periods of madness grew longer–three months of agitation followed by two of deep depression–and her needs greater, Charles simply moved into a private ‘madhouse’ with her. It seemed more straightforward. After all, he couldn’t live in any way, and certainly not happily, without her. Walking in Edmonton just before Christmas 1834, not far from the custodial house they lived in, Charles, more than likely drunk, fell over, contracted blood poisoning and died of erysipelas a week later. He had been mourning Coleridge’s death since July that year. Mary lived on for another twelve years. Surprisingly perhaps, for the first three years after Charles’s death she was remarkably well, almost, one could say, released into good health. After that her periods of madness lengthened. She died in May 1847 at the ripe age of eighty-two.

  CRIMES AND DOCTORS

  It may be that one reason Mary stressed the mad person’s need for tenderness of treatment is that she had experienced, or at least witnessed, the brutality the confined could encounter within the madhouse. Sarah Burton, Charles and Mary’s most recent biographer, states that Mary spent time in the Whitmore madhouse or at Warburton’s, about which an anonymously published report of 1825–found to be by John Mitford, a journalist and former inmate–catalogued a range of horrors that keepers perpetrated on even the better class of inmates. A young married lady was ‘so forcefully fed that her teeth were falling out and her gums were putrid’. She died in great misery. Another, named as the daughter of the Chief Clerk to the Secretary of State, was beaten on the breast with a broomstick and ‘prostituted on the steps leading to the lodge by more than one keeper’. When complaints were lodged, the head of the madhouse, Warburton himself, said, ‘It is no matter, she don’t know what is done to her.’ Flogging, stealing of clothes and then reporting to family that these had been ripped by ‘the great destroyers of apparel’ the mad were known to be, refusing to allow the patient to see family alone so that she might report on mistreatment–all this was commonplace, according to Mitford.

  A report by John Wilson Rogers, a visiting physician at Warburton’s paupers’ asylum in Bethnal Green, ten years earlier, was equally damning. The catalogue of abuses he lists includes chaining to bedposts for hours, and simultaneous beating; filthy infected sores brought on by chaining, the inability to move, the general filth, gagging or bandaging of the whole head to prevent talk, force-feeding of such brutality that spoon handles punctured the mouth; suffocation, blinding.

  According to Andrew Roberts, whose Middlesex University website is a remarkable and detailed source of data on the history of madness and asylums in Britain, Mary Lamb was certainly never a pauper patient at Warburton’s in Bethnal Green; nor would her and Charles’s finances have permitted confinement at the expensive Whitmore’s. Roberts argues that the madhouse Mary was regularly confined in was Hoxton. Following this line would mean Charles Lamb’s assertions that his sister was on the whole well treated by her keepers are based neither on his ignorance, nor on his guilt. Equally this would mean that Mary reported no terrible abuses, not because she was frightened or failed to remember them, but simply because she experienced relatively good care.

  Good care did not mean cure. There was no therapeutic intent linked to the institutions where Mary stayed. They were simply places of confinement: a way of removing her from the danger she posed to others and herself and perhaps ‘calming’ her. Of the two doctors who make an appearance in Mary’s case, one, however, does seem to have done her some good. This is Dr George Leman Tuthill (1772–1835), who applied around the time he was treating Mary for a post at St Luke’s, the large private asylum founded by the reformer Battie. He was unsuccessful but in 1816 was appointed joint physician to Bethlem and Bridewell. So he had more than a passing interest in madness.

  ‘I was then so ill as to alarm him [Charles] exceedingly,’ Mary writes to Dorothy Wordsworth on 13 November 1810, ‘and he thought me quite
incapable of any kind of business…I am at present under the care of Dr Tuthill. I think I have derived great benefit from his medicines. He has also made a water drinker of me, which, contrary to my expectations, seems to agree with me very well.’

  Tuthill, who had been imprisoned by Napoleon and had his attractive wife to thank for his release, was, in 1810, only at the beginning of his career, but his rise was meteoric. He was a chemist, a popular lecturer in physic, and was knighted in 1820. Part of the Lambs’ social circle (Charles mentions his imprisonment in France in a letter of 1806), he was the doctor who wrote the letter which obtained for Charles his long-awaited retirement from the East India Company in 1825. Tuthill was active in producing the new edition of the Pharmacopoeia Londiniensis of 1824, the original of which had appeared in 1618 and was the basic treatise for apothecaries in their preparation of medicines. Compound remedies arranged by class–waters, ointments, lozenges–were listed, many of them as old as Galen and Avicenna. Tuthill, with a committee, brought the whole up to date and he was largely responsible for its appearance in English. According to one source, Tuthill ‘spoke in quick, short sentences, seldom uttering a word more than the occasion required, or omitting one that was necessary’.

  It is not clear what Tuthill prescribed for Mary from his pharmacopoeia, aside from water. Opium and laudanum were both used at the time to still fits, but there is no record of Mary taking either. Tuthill did, however, seem to calm her through an enforced regime of rest, or what she thought of as ‘idleness’: she was to do no work, see friends as little as possible and go to bed early–a set of prescriptions which were to attend women diagnosed with hysteria or neurasthenia throughout the latter part of the century and into the next. Under Tuthill’s care, Mary’s bouts of mania moved more rapidly towards recovery than when she was confined to Hoxton. Perhaps the singleness of his attention helped. Nor is it clear what Tuthill prescribed for Charles, whose controllable depressions were not infrequent, but the waters may have done him good as well, particularly as a relief from alcohol. This dietary management follows a direct line from Cheyne. Indeed, taking the waters of various kinds remained one form of treatment for both sadness and madness throughout the nineteenth century across Europe. From our chemical twenty-first, we may look back sceptically, but these mineral waters often enough contained the basis of some of our contemporary drugs, for example lithium.