Charles Dickens and PTSD

Generally, I'm not a fan of reading contemporary ailments onto historical figures, but, while searching for more information on Bunbury, which is only remotely connected to my novel at this point, I came across Nicholas Daly's article on railway novels. The introduction to his article left me convinced that Charles Dickens had post traumatic stress disorder (PTSD).

On June 10, 1865 the London Times reported a "Dreadful RailwayAccidentat Staplehurst:10 Persons Killed-Upwards of 20 Wounded."One of the passengers, who had "a narrow escape . . . fortunately for himself and for the interests of literature,"was Charles Dickens. The previous day the 2:38 tidal train from Folkestone had come off the rails at the viaduct just outside Staplehurst. The track was being repaired at the time of the accident and a section of it had been taken up. Having read the wrong time-table, the foreman in charge of the repairs did not expect the train for another two hours, and by the time the train driver saw the flag man who was in the wrong place it was much too late to brake. The front of the train cleared the gap in the tracks, but the rest of the carriages plunged down into the river bed. Only one of the seven first-class carriages escaped the fall by being securely coupled to the second-class carriage in front. In that fortunate carriage were Charles Dickens, his mistress, Ellen Ternan, and her mother. Also present was the manuscript of Our Mutual Friend, which, famously, Dickens rescued from the precariouly balanced carriage, after first extricating the Ternans and offering assistance to the injured and dying. Ellen Ternan appears to have been hurt in the crash, but Dickens felt no ill-effects until he was back in London, when he describes himself as being "quite shattered and brokenup." "Shaken"is the word that he uses to describe his nervous condition in letter after letter. On June 10 he apologizes to Charles Lever that he "can't sign [his] flourish, being nervously shaken." On June 13, in a letter to Thomas Mitton, he describes himself as still reliving the original impact:" In writing these scanty words of recollection I feel the shake and I am obliged to stop." On June 21 he still feels "a little shaken in [his] nervous system by the terrible and affecting incidents of the late railway accident." And the effects lingered long after, as Peter Ackroyd describes:

["]The effect of the Staplehurst accident "tells more and more," [Dickens] noted in 1867, and then a year later he confessed that ". .. I have sudden vague rushes of terror, even when riding in a hansom cab, which are perfectly unreasonable but quite insurmountable." His son, Henry, recalled that "I have seen him sometimes in a railway carriage when there was a slight jolt. When this happened he was almost in a state of panic and gripped the seat with both hands." And Mamie remembered that ". .. my father's nerves never really were the same again ... we have often seen him, when travelling home from London, suddenly fall into a paroxysm of fear,  tremble all over, clutch the arms of the railway carriage, large beads of perspiration standing on his face, and suffer agonies of terror. We ... would touch his hand gently now and then. He had,  however, ... no idea of our presence"["] 

Although Dickens got off lightly in the accident itself, then, the original jolt seems to have left its mark on his body, to have filed itself away in his nervous system; he relived the event over and over, experiencing all the anxiety that he didn't feel at the time. He died on the anniversary of the crash five years later. As Wolfgang Schivelbusch notes, we can identify Dickens as one of the most famous victims of a peculiarly modem form of nervous after-effect: shock.

"Shock," specifically shell-shock after the First World War, was what helped modern doctors identify PTSD. PTSD is most common among veterans, but it can happen to anybody that has experienced a traumatic event. Symptoms usually become evident 1-3 months after the event. About half of all Americans with PTSD never seek treatment. About 21% of those who do get inadequate treatment.

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The No-Nose Club and Victorian STDs

Victorian sexuality can be approached from so many directions, including (but not limited to) body image, sexual orientation, masturbation, prostitution, sex education, disease, religion, marriage, and pornography. All of these aspects overlap and influence each other, creating tremendous diversity in attitudes toward sex at any given point in history. Each of these factors provide the context in which sexual identities are created. This post is the sixth in a series of posts that seek to explore that context from the 1890s with an emphasis on male sexuality.

Disease

Speaking about disease within the context of sexual identity, the first that come to mind are sexually transmitted diseases (STD). Other diseases also play a big role in how we identify as sexual human beings across gender lines. Illness even makes us feel irresponsible today: not just blaming ourselves for getting sick, but also feeling that we should have been better prepared for such an event. Consequently, health plays a huge role in any person's sexual identity, as does the fear of getting sick.

Victorian, and other historical, illnesses are approached with hindsight, and we can't talk about sexual identity and disease without talking about STDs. From where I sit, literary historians like to read the most common Victorian STDs onto historical figures. Oscar Wilde did not die of syphilis; there's also no solid emphasis that Bram Stoker had it. Yet, we seem obsessed with reading these diseases onto our beloved authors.

Things were quite different at the time. 

'Morality' was central to the very heterosexist racist society that was London, and the rest of the English-speaking world, in the 1890s. Morality was a concept they used to condemn the things they didn't like, including sex, women, foreigners, poverty, and disease. 

Cartoon from The Wasp (San Fransisco) of May 26, 1882,
promoting the then-common racist myth that diseases
were rampant in Chinatown. (Source)

One of the most outstanding examples of how Victorians used illness to shame the sick is Max Nordau's Degeneration (1895).

A race which is regularly addicted, even! without excess, to narcotics and stimulants in any form (such, as fermented alcoholic drinks, tobacco, opium, hashish, arsenic, which partakes of tainted foods (bread made with bad corn, which absorbs organic poisons (marsh fever, syphilis, tuberculosis, goitre), begets degenerate descendants who, if they remain exposed to the same influences, rapidly descend to the lowest degrees of degeneracy, to idiocy, to dwarfishness, etc. That the poisoning of civilized peoples continues and increases at a very rapid rate is widely attested by statistics.

Degeneration was translated to English three years after its initial publication, and introduced to London at a time when they were starting to talk more seriously about STDs.  Coincidently, 1895 is the same year Wilde went to prison. The book maintained ideas that were popular outside the bohemian set; chiefly, that lust was incompatible with intellect and artistic genius.

Women were still blamed for the spread
of STDs in WW2 propaganda posters

If the statistics Nardau refers to existed, they were, at best, misleading. Victorian doctors did not yet possess the means of accurately diagnosing STDs, and were as likely to overlook STDs, as they were to over-diagnose them. Wealthier people would have been seen outside of hospitals, and could expect their doctors to be discreet. Autopsies usually only superficially identified cause of death, such as which organs failed, though they might not know why.

They knew that STDs existed, and primarily blamed prostitutes, as is evidenced by the Contagious Diseases Acts, originally passed in parliament in 1864. 'Blame' is even too light a word, in this context. If a female sex worker was believed to have a STD, she would be locked away in a special hospital, until 'cured' - only there wasn't enough room in these Lock Hospitals (that's actually what they were called), so she was more likely to end up in a workhouse infirmary. Those laws were repealed in 1885, but the prevailing attitude toward sex workers and disease hadn't really changed by the 1890s.

Still, I am trying to talk about how STDs impacted a man's sexual identity in the 1890s. The state didn't do anything to the men, who had slept with the infected sex workers. In one sense, these men were left to fend for themselves, to find their own treatment. I don't know how many saw doctors. Their doctors were very discreet, after all. More realistically, they continued sleeping with sex workers, and spreading their infections.

Origin of the No Nose Club. Star, Issue 1861,
18 February 1874, p. 3. (Source)

The idea of catching an STD would have been terrifying, and a little unbelievable. As I've mentioned before, sex education wasn't very popular yet, and rumours were abundant. Indicative, of what men imagined from an STD was the No-Nose Club, which Linda Dowling calls, "an imaginary assembly of beakless sufferers of syphilis." They imagined that the signs of such terrible diseases would be quite obvious.

"The Martyrdom of Mercury," (1709).

If one didn't have symptoms, one couldn't be sick! Antibiotics weren't used to treat the disease until 1905-1910. For a man in the 1890s, having an STD was probably a secret shame, akin to masturbating. Admitting you had it or did it was akin to admitting you were a crazed pervert. Treatment with mercury was most common in the 1890s, and that was worse than the symptoms of infection, which brings us back to the spreading of diseases. It was as John H. Stokes wrote in 1920:

The third great plague is syphilis, a disease which, in these times of public enlightenment, is still shrouded in obscurity, entrenched behind a barrier of silence, and armed, by our own ignorance and false shame, with a thousand times its actual power to destroy. . . . It is one of the ironies, the paradoxes, of fate that the disease against which the most tremendous advances have been made, the most brilliant victories won, is the third great plague, syphilis the disease that still destroys us through our ignorance or our refusal to know the truth. (Source)

Shame kept people from getting treatment, so people died from their illnesses. Our beloved Mrs Beeton, of the  popular household management book, a pillar of society, died of syphilis, contracted from her husband. It may have also killed her first two children. I mention Mrs Beeton because her case demonstrates that there is no shame in getting sick. She bought into Victorian morality wholeheartedly, and it did nothing to save her.

Lee Jackson tells the story of another innocent woman, who died of syphilis, and concludes: "Who could have seen that hapless, unoffending victim to her woman's trust and man's barbarity, hurried to an early grave, without asking himself could such a one have been marked out for example and for punishment by a discerning Providence, as some would tell us?"

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The Charlatans of the 1890s Anti-Masturbation Movement

Victorian sexuality can be approached from so many directions, including (but not limited to) body image, sexual orientation, masturbation, prostitution, sex education, disease, religion, marriage, and pornography. All of these aspects overlap and influence each other, creating tremendous diversity in attitudes toward sex at any given point in history. Each of these factors provide the context in which sexual identities are created. This post is the third in a series of posts that seek to explore that context from the 1890s with an emphasis on male sexuality.

Masturbation

Onanism is another word for masturbation that was popular in the 1890s.

Masturbation is a natural part of human life. Many adults and children even do it in their sleep. In the 1800s, it was generally believed that masturbation was bad for you - real bad. Although women masturbate too and precautions were taken to prevent them from doing so, the anti-masturbation movement primarily focused on men. 

Throughout the 1800s and into the mid-1900s, charismatic charlatans and money-hungry doctors throughout the Western World and its colonies continued to cash in on the anti-masturbation craze by selling snake oil and sadistic appliances to the masses. Most of these devices operated on the principle that aversion therapy - teaching men to associate fear and pain with genital stimulation - would put an end to masturbation. Among the numerous devices manufactured to cure self-stimulation: a "Penis Cooling Device," invented by Frank Orth (1893); the Stephenson Spermatic Truss (1876); a saw toothed steel penis ring to prevent erection (1908); a leather and steel penis "corset," invented by a Dr. Fleck (1931). These and dozens of other types of cages and chastity contraptions were routinely used on boys and men, not only in the spas and clinics run by the charlatans, but in hospitals and mental wards throughout Europe and North America, where psychiatrists eagerly applied themselves to the task of " curing" male masturbation by causing intense pain to their genitals. - Gloria G. Brame, The Truth about Sex, a Sex Primer for the 21st Century: Sex and the Self (2011).

 One of the most famous anti-masturbation advocates of the 1890s was John Harvey Kellogg of Kellogg's cereal. He may rightly be considered one of the charlatans that Brame refers to above, because he made a lot of money through his sanatarium and anti-masturbatory Corn Flakes cereal.

John Harvey Kellogg

Typical of the medical professionals of the era, Kellogg advocated sexual abstinence. He discouraged sexual activity for both medical and moral reasons, which he learned through the  Seventh-day Adventist Church, but were broadly supported at the time. He wrote books about abstinence, and believed the diet he was prescribing would reduce the sexual urges of its adherents. Kellogg loved enemas for this reason, and, like Frank Orth, the inventor of the 'Penis Cooling Device,' Kellogg supported the 'benefits' of hydrotherapy.

Frank Orth's Penis Cooling Device.

Kellogg was even against excessive sex within a marriage, and any sexual acts that were "against nature." Legend has it that Kellogg even spent his honeymoon writing one of his books on abstinence.

In his campaign against masturbation, Kellogg drew upon contemporary scientific rumors of masturbation-related deaths, in "such a victim literally dies by his own hand." Many of his contemporaries joined him in the claim that masturbation caused cancer of the womb, urinary diseases, nocturnal emissions, impotence, epilepsy, insanity, as well as numerous other disabilities.

Kellogg set out to rehabilitate masturbators through extreme measures, including genital mutilation of both sexes. He advocated the circumcision of young boys without painkillers to curb masturbation, and the application of phenol to a young woman's clitoris. He produced cages for boys' genitals and electric shock therapy.

People, like me, pick on Kellogg because he is a recognizable figure, who promoted harmful ideas. In context, Kellogg's ideas were as commonplace as viagra is today. Out of context, circumcising a guy of any age to keep him from masturbating sounds barbaric, but today's widespread circumcision of boys began in the late-Victorian era for this reason.

Medical Reference
(28 September 1895).

As late as the 1860s, circumcision was viewed primarily as a Jewish practice, until doctors began to view it as a way of preventing men and boys from masturbating. One 1895 medical journal calls circumcision "the physician's best friend and ally" because it "provides immunity from after-reproach." The same medical journal claims:

...should there be any play the patient will be found to readily resume his practice, not begrudging the time and extra energy required to produce the orgasm. It is true, however, that the longer it takes to have an orgasm, the less frequently it will be attempted, consequently the greater the benefit gained.

This journal advocates early circumcision, but says that if performed before puberty, it might have to happen again! Yikes! It also greatly advocates circumcision on men over fifty because they are less likely to suffer "the mental depression" that was sometimes observed after the fact in younger patients. However, they felt that passed that age masturbation has little effect on a man's health.

So, if doctors in the 1890s really believed all this nonsense, does Brame go too far in calling them charlatans? In some cases, these doctors were absolutely charlatans! Harry Finely makes the point that with all of the anti-masturbation propaganda circulating about, these 'doctors' had a very guilty and captive audience because almost everybody has masturbated at some point in their life. Combine that guilty conscience with a $10 instant cure, and these doctors definitely turned into charlatans.

I would compare it to the distribution of viagra today. Many men worry about their ability to get and maintain an erection, which has resulted in the over-prescription and abuse of medical aids, like viagra. Doctors, today, don't make extra money for writing a prescription, they worry for their patients, and I think many misguided doctors felt the same way regarding their patients concerns over masturbation in the 1890s.

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English Horror Story: Asylum

Patients in a Victorian Asylum (from the BBC).

Part of Dracula is set in an insane asylum because they were definitely scary! Bram Stoker used to visit them with the actress, Ellen Terry. She was studying for roles, or something, but visiting the asylum to look at the lunatics once a week was a disturbingly popular Victorian pastime, as evidenced by the portraits Henry Hering took of patients in the late 1850s.

Eliza Camplin

Eliza Camplin's portrait is decidedly posed. She didn't like the dress she was wearing, and insisted on sitting with a book (which she is holding upside-down).

The photos of Harriet Jordan are also interesting.

Harriet Jordan, diagnosed with mania.

Harriet Jordan, a few months later.

I wonder if Jordan was pulling herself together because she wanted to get out of there.

Hering took his photos at Bethlem Hospital, and Stoker gives us the impression of a great big asylum, but most people 'diagnosed' with Victorian mental conditions were simply locked away in the private homes of non-medical men, who set up to profit from these arrangements. Families paid for secrecy and discretion.

Hospitals used padded rooms to keep patients from injuring themselves.

Photo by Henry Hering.

Perhaps the most terrifying aspect of the Victorian mental asylum was how easily women could end up there. London's most successful female journalist and newspaper editor wound up in one after her husband died because her family didn't like her and wanted her money.

Women were thought to be at particular risk of mental illness caused by supposed disorders of the reproductive system. Cases of melancholia associated with the menopause were treated with leeches to the pubis. The male doctors of the day saw ‘hysteria’ – from the Latin for womb – everywhere; almost any form of behaviour, such as excited chattering with other women, could be diagnosed as hysteria. - Wendy Wallace

Photo by Henry Hering.

I must admit that I felt a bit hypocritical selecting these photos to share, after mocking Stoker for his asylum tourism. In a way, we are all becoming asylum tourists by scrolling through this blog, but the images haunt me because of the deep sense of empathy and sadness I feel for each of the patients portrayed.

I'd venture to say that these people were lucky to end up in Bethlem - not in some fake doctor's private home.

More photos by Henry Hering

Though not all of Hering's photos are women, women were the primary subjects of psychiatric care that focused on sexual disorders.

Treatments included: calomel (which was really just mercury); antimony (a chemical we now use in fire retardants) to keep patients in a constant state of nausea (if they were nauseous, they were less likely to be violent); cold baths; cold showers; cold applications to the uterus (I don't even want to think how that was arranged); I personally prefer cycling for the insane. Electric shock therapy, and the lobotomy were both also invented during this time as a form of treatment for mental patients.

Cycling for the Insane' was an article published in a late-Victorian medical journal about the benefits of cycling for mental health patients. It reflects a movement to treat medical problems with moral solutions, a trend also reflected in the number of institutions established and constructed during the nineteenth century.

Doctors working in these mental institutions exaggerated the success of their methods. More patients poured in. By the 1890s, most died there.

Many mental hospitals closed in the 1970s and 1980s. This was due to pressure from the antipsychiatry movement, feminist criticism, ex-patient activism and political suspicion of large, unaccountable institutions. - The Science Museum

Throughout October 2014, I will be sharing the horror stories of 1890s London. Check back often!

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Cycling for the Insane

Feeling down? Get outside and ride your bike! That’s the advice C. Theodore Ewart M.D. Assistant Medical Officer at the Leavesden Asylum put forward in his article: “Cycling for the Insane,” published in the Journal of Medical Science (July 1890).

It’s easy to look back at the scientific ideas of the past and poke fun, but this idea of exercising for depression and other issues of mental and emotional well-being hasn’t died off at all. To me, this is like adding insult to injury, telling a person, who is already down, that they are also lazy. There is some merit to Ewart’s ideas. I certainly find some relief from doing exercises when I’m feeling down, but, when Ewart wrote the following, he couldn’t have been discussing a cure-all.

Rushing through the air at 12 miles an hour, will lift the gloomiest thoughts from the mind, be it only for a short period, and what torpidity of soul is not surmounted by the continuous, delicate interaction of nerve and muscle!

Surely, none of the patients at the Leavesden Asylum suffered from agoraphobia.

I joke, of course, but I did find some real value in reading this old article. I got to look up pictures of Victorians on bicycles and tricycles and it is an interesting reflection of what was happening culturally at the beginning of the 1890s. Bicycles were still considered a new thing. When Ewart writes about riding them, he talks about “operating the machine” and this was a hip topic in 1890.

The object of the following remarks is to discuss the question of cycling purely in its relations to health. No attempt will be made to give a history of its growth from the “dandy-horse” and “bone-shaker” to the roadster, racer, tandem, and sociable. A knowledge of cones, balls, spoon or band brakes, of steering and gearing, although practically useful, has little direct bearing on the hygienic aspect of this pursuit, with which alone we are here concerned.

 

 When the ordinary non-cycling observer sees a rider gliding quietly along a bit of smooth roadway with apparently the least possible expenditure of muscular power, he is apt to believe that speaking of bicycling as “exercise” in the ordinary acceptation of the term is to be guilty of culpable exaggeration. ... he will be inclined to suggest that bicycling exercises only the legs, and that on this account it falls short of the standard of ideal exercise.

When Ewart uses the word “hygienic” above, we all know that he meant “healthy” and didn’t mean to imply that riding a bike was like disinfecting your hands or taking a shower. For example, “hygienic dress” was something many middle-class reformers were all about, when it come to the hazards of tightly-laced corsets and women’s health.

It seems that, in writing this piece, Ewart was negotiating some tricky and complicated territory. He uses the pronoun “he” a lot to talk about people in general, but he really wants to talk about women because they made up most of the population of his asylum and Victorians had this view that women were fragile and shouldn’t be subjected to vigorous exercise, but he does want to say that they should exercise.

The main feature of the exercise is not so much the propulsion of the machine as the balancing of it - the adjustment of the body in its application of motive power in such a manner as to secure and equal distribution of its weight on each side of the direct line of motion.

But, don’t discount it as anything less than marvelous just because it’s easy.

For any exercise to take a really high rank, it is requisite that it should be taken in the open air, and in this respect few, if any, can approach cycling.

Building up cycling as an acceptable and useful exercise for insane women wasn’t enough for Ewart.

He had to take down walking.

A walk may often be a dull affair, the fixed natural objects passed may be too familiar to the walker, who, from the comparatively limited area at his command, has of necessity to traverse the same ground; variable objects, animate and inanimate, do not present themselves with sufficient rapidity to break the spell of monotony. The cyclist, however, need never find his ride dull - he has a larger range at his command, the number of objects of interest he passes is multiplied by his pace, and the mind is supplied with a constant succession of occasions for pleasant observation.

Sports were gaining popularity among women by the 1890s, but connotations of the New Woman still accompanied women’s fitness and healthy living. Ewart was aware of this trend and, as a professional working in an insane asylum, he was also aware of the higher rates of institutionalized insanity among women.

It is impossible to over-estimate the value of any out-door exercise which provides itself both suitable and attractive to women, and there is nothing whatever in the nature of the exercise to render the use of the use of the tricycle of more service to one sex than to the other, whereas the greater degree of confinement in the asylum to which the female patients are necessarily subjected, and the more restricted number of out-door exercises which are open to them, render it all the more important that this recent addition to the list should receive full and general recognition.

Of course, Victorian women weren’t more prone to mental illness any more than their male counterparts, but their male counterparts had significant power over their lives, which easily led to abuse. The husband, father or guardian of a Victorian woman of any age (if she were older this could be her son) could and did have women certified as insane without doctors ever talking to her. Hysteria was a popular diagnosis, but epilepsy, infidelity and independent thought were also reasons women found themselves in asylums, like Ewart’s Leavesden.

That being said, Ewart talks about them like they are just really sad and ought to ride a bicycle.

For most of us the exquisite loveliness and delight of a fine summer’s day have a special charm. The very life is luxury. The air is full of sound and sunshine, of the song of birds, and the murmur of insects; the meadows gleam with golden buttercups, we almost fancy we can see the grass grow and the buds open; the bees hum for very joy; there are a thousand scents, above all, perhaps, that of new-mown hay. There are doubtless many patients before whom “all the glories of heaven and earth may pass in daily succession without touching their hearts or elevating their minds,” but, in time, it is possible even these would, by means of cycling, have their love of Nature, which had been frozen or crushed out, restored. Thus all Nature, which is full of beauties, would not only be a never-failing source of pleasure and interest, but lift them above the petty troubles and sorrows of their daily life.

Though “Cycling for the Insane” seems to be written from a place of compassion, it reveals a basic lack of understanding of mental illness within the institutions Victorians built to cope with mental illness. I say that Ewart writes from a place of compassion because I know that many institutions treated their patients like side-show freaks.

Though Ewart writes to encourage other asylums to adopt and encourage exercise regimens that include cycling for women, this piece reads like general advice on how to stay healthy and mentally stable, even though it was published in the Journal of Medical Science.

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