Gender and Insanity as Characteristics of the Insane: A Nineteenth

Gender and Insanity as
Characteristics of the Insane: A
Nineteenth-Century Case*
WENDY haCHINSON
Since the mid-1960s, social control has been a major explanatory model
in accounting for the emergence and development of insane asylums. l
Of specific concern was the introduction in the late eighteenth and
early nineteenth century of "moral treatment." Historians have debated the reasons for its introduction and its value endlessly, and while
the debate has added greatly to our understanding of asylum reformers and bureaucracies, it has not contributed equally to our understanding of who the insane were. Recent studies have begun to do
thk2
The new focus on the patient, rather than the asylum bureaucracy,
has relevance for today. The incidence of mental illness is increasing,
yet our understanding of it has not improved ~ignificantly.~
It may
prove of benefit to discern who the insane were in the past and to learn
whether any distinction was made between different groups of the
insane. This paper attempts to do so, using gender as the separating
variable. Gender is focused on in order to see how systemic sex-role
stereotyping was in the mid-to-late nineteenth century. Certainly the
tendency to define hysteria as a female disease suggests a willingness
on the part of many to perceive women as more susceptible than men
to nervous or mental disorders. Did this also hold true for insanity?
The results of this study raise questions about the social control
model of asylum care. Focusing on the socioeconomic characteristicsof
the insane shows clearly that the asylum was not being used as a place
to hide away the deviant or the idle (as is often suggested in the social
control literature) except to the extent that mental illness was defined
as deviancy and led to an inability to work. The insane, both male and
Wendy Mitchinson, Department of History, University of Waterloo, Waterloo,
Ontario N2L 3G1
Received 10 July 1987; accepted 16 July 1987.
CBMHIBCHM 1 Volume 4: 1987 1 p. 99-117
100
WENDY MITCHINSON
female, stood out from the sane population only in the symptoms of
their illnesses.
Asylums in nineteenth-century Ontario are an excellent focus of
study for the historian of insanity. As the century progressed, the
number of people who were being incarcerated increased. In 1874 the
Inspector of Asylums estimated that one out of every 397 people in the
province were insane and that one out of every 1,120 was in an a ~ y l u m . ~
By 1883, the Medical Superintendent of the Toronto Asylum estimated,
probably optimistically, that 90 percent of Ontario's insane were in
asylum^.^ Thus when asylum inmates are examined the majority of
those deemed insane are represented. For the purposes of this paper,
the committal and case records of every tenth patient at the Provincial
Asylum for the Insane in Toronto between the years 1841and 1900were
examined. This resulted in a sample of 862 patient^.^ The socioeconomic characteristics of the patients were examined as were their
method of entry into the asylum. An assessment of their symptoms has
been made elsewhere.'
THE TORONTO ASYLUM
I
For many years the Provincial Lunatic Asylum was the only such
institution in the province of O n t a r i ~In
. ~1830, the Assembly of Upper
Canada approved the spending of monies to support the insane in the
Home District and in 1833this was extended to the rest of the province.
No provision was made to build an asylum until 1839 and it did not
open until 1850. Until then, the insane were either kept with their
families, placed in local jails, or incarcerated in the temporary asylum
established in the old York jail in 1841. Bureaucratic disruption characterized these years and continued into the early history of the new
asylum. In 1854, however, Joseph Workman was appointed Superintendent and he administered the asylum until 1875. His successor
lasted two months and was succeeded by Daniel Clark, who remained
for the rest of the century. Thus for much of the period under study the
asylum had a strong continuity of management.
From the beginning the asylum proved much used and it quickly
became overcrowded. Extensions were made and satellite buildings
p u r c h a ~ e dIn
. ~ 1870 a second asylum opened in London, followed by
one in Hamilton in 1879, Mimico in 1890, Brockville in 1894, Cobourg in
1902, and Penetanguishene in 1904.1°All were run by the province and
were state supported. Only the Homewood Retreat, in Guelph, which
opened in 1884, was a private asylum."
If success is measured by how many people were committed, then
the Toronto institution was successful. Whether for control or cure, it
was being used. When the new building opened, 211 patients occupied
it.12 By 1899 there were 867 patients.13 Until the late 1870s it was the
Gender and Insanity as Characteristics of the Insane
101
largest asylum in the province; then, the new asylum in London
superseded it. However, Toronto remained one of the larger asylums
and, because it was the first to be established, considered itself the
premier institution in the province for the care and treatment of insanity.
GENDER DIFFERENCES
Elaine Showalter, in her study on Victorian women and insanity, has
noted that women were incarcerated more than men in nineteenthcentury English asylums. Her explanation for this was the fact that
women, compared to men, stayed in asylums longer, that they experienced a lower death rate, and that their relative poverty put them at
risk.14 Such factors reveal much about the profile of the female insane
and the admissions policy of asylums but little about the actual numbers of insane women in society or the rate of incarceration.
The situation was slightly different in Canada. According to the 1891
census, there were 13,355 insane in the country of whom 7,162 were
male (29.1 males per 10,000 population) and 6,193 were female (26.1
females per 10,000 population).15In Ontario asylums, equal numbers
of men and women were admitted. In Toronto, from1841 to September
1899, the number admitted was 8,545,4,435 men and 4,110 w o m e n , s
51.9 percent men and 48.1 percent women.16 This was a result
deliberate policy, for from the beginning equal numbers of beds were
set aside for men and women. The only era when there was any kind of
significant difference in numbers was the 1840s and early 1850s. From
1841until 1854,1,568 patients were admitted, 893 men and 675 female.
Workman explained the differenceby the fact that in the early years the
female insane were "less dangerous and more easily managed at
home."'' Also in the 1840s the asylum was in a former jail and many
families may have been hesitant to place female relatives in such a place
and in what was essentially an untried institution. As the work of the
asylum became known and as the publicity about "moral treatment"
emphasized the domestic atmosphere of the asylum, women were
incarcerated in the same numbers as men. However, there were many
more insane men in the population than were admitted to asylums.
The explanation for this was not that insane women were incarcerated
more but that they were incarcerated differently. Although asylums
continually were being built in the nineteenth century, all quickly
became overcrowded and, as a result, many of the insane remained in
jails. Most likely, this happened to men more than women.
of
METHODS OF COMMITTAL
This hypothesis gains credence when the entry pattern to the asylum is
examined for both sexes. There were basically two ways of being
102
I
WENDY MITCHINSON
admitted: through the normal committal system and through the warrant system. For most of the century, committal to the asylum necessitated a certificate of insanity signed by three physicians.ls At that point
the asylum could accept the individual if there was a vacancy, although
there was some debate over whether priority should be given to acute
cases over chronic.lg Clearly such a system favored those in urban
areas. Even at the end of the century, people in the rural districts of the
province would have had difficulty obtaining access to more than one
physician. In addition, such a system did not guarantee entry to the
asylum because admission was linked to vacancies. As a result, many
entered by way of a warrant.
The warrant system was designed to incarcerate those insane who
came to the attention of the authorities. A warrant could be issued by
any Justice of the Peace when informed that a person was "insane and
dangerous to be at large, and has exhibited a purpose of committing
some crime for which if committed such person would be liable to be
indicted."20The accused lunatic would be brought before the Justice
and could be placed in jail while an inquiry into his or her insanity was
made. If found insane (and this had to be confirmed through the
examination of two physicians, one of whom was the jail surgeon), the
individual was put in jail until a Lieutenant-Governor's warrant was
issued transferring him or her to the asylum.21Such a warrant had to be
acted upon no matter how crowded the asylum was. Warrant cases
thus had'precedence over private cases and, as a result, many individuals entered the asylum in this manner even though their actions may
not have demanded it. In 1859, Workman pointed out that "Fully
one-half of all the patients now reaching this Asylum are transmitted
from the country gaols," and worried that their stay in the jail would
prove disadvantageous to their eventual recovery.22 But although
Workman and his successor, Daniel Clark, disapproved of the use
made of the warrant system and its repercussions on the insane, there
was little either could do.
By 1886, Clark had accepted this fact and was himself perverting the
system. The case of Annie S. (6090) was typical. In 1886 her brother
wanted her admitted to the asylum but Clark wrote back saying that
there was no room. If she was troublesome, he advised the brother that
his best chance was to have her committed to jail as a lunatic and from
there she would be admitted.
Altogether, in the period under study, 45.6 percent of admissions
came from jail, 49 percent from the family, and the rest from other
institutions or through other means. Until the end of the 1870s those
admitted from jail outnumbered those admitted from the family, but
after that period the latter dominated. This decline in warrant cases is
not particularly significant, for after 1879Toronto became the asylum to
which paying patients were sent and they tended not to enter through
Gender and lnsanity as Characteristics of the lnsane
103
the warrant system.23Thus the fact that the percentage coming from
jails remained as high as it did is a telling commentary on the committal
system (see Table 1).
Table 1
Year of Admission by Type of Commitment
Decade
Jail
Family
Other
Row
Totals
Column
Totals
"Number
bExpectedvalue
cRow percentage
*Column percentage
Wheq the two committal systems are examined, the hypothesis that
insane men were more likely than women to be sent to jail gains
support. Between 1841 and 1899 there were 1,780 warrant cases of
whom only 598 were women.24Throughout the entire century there
was a significant correlation between the sex of the patients and how
104
l
WENDY MITCHINSON
they entered the asylum. Men more than women entered the asylum
by warrant. What is more, not all those who entered jails as insane
were transferred to the asylum. In 1856,21 insane people remained in
jails.25By 1874 this number had increased to 43.26In 1888, the Inspector
of Asylums expressed his concern over the number of insane languishing in jails' due to overcrowding in asylums.27Since men generally
entered the asylum through the warrant system, the likelihood is that
those who were languishing in jails were men. The female insane
tended to enter the asylum through family committal. They did not
come to the attention of the authorities as much as men, their
symptoms of insanity perhaps being less violent than the male insane.
In addition, families may have been more willing to commit their
female insane than their male, feeling that the stigma attached was less
serious for a woman than for male heads of families. Also, the female
insane were perhaps more likely than the males to have close family
nearby. One indication that this may have been the case was the
marital status of those committed. Single persons represented 57.4
percent of the total who entered the asylum through the warrant
system and married persons represented 38.9 percent. And women
entering the asylum were more likely than men to be married, 51.7
percent compared to 42 percent.2s
The conclusions from this are perhaps surprising. Women were not
incarcerated more than men, in fact they were incarcerated less when
the number of insane men in jails is taken into account. But women
were much more likely to be incarcerated through the wishes of their
families. It is difficult to know how to interpret this. If the asylum was
seen as a place for cure, then committal was a sign that the family
cared. If it was not seen as a place for cure, it may suggest that the
family was more willing to rid itself of the burden represented by the
female insane than the male. But even this may not suggest an uncaring attitude as much as a practical one. Women, more than men, would
be more present in the household and thus more disruptive, especially
if there was no other adult within the family to care for them. The
family simply may have been unable to cope. Whatever the reason,
many female insane were spared the humiliation of a jail committal and
were thus treated as ill and not criminal.
PAYING PATIENTS AND PAUPERS
Another aspect of how people entered the asylum was whether they
paid or not. Generally speaking, fees in state-sponsored asylums were
determined by one's ability to pay. The practical consequence of being
a paying patient was access to more amenities within the asylum.
Throughout the period under review, the province of Ontario supported 64.4 percent of the patients in the Toronto asylum. This does not
Gender and Insanity as Characteristics of the Insane
105
mean, however, that 64.4 percent of the patients were paupers. Many
would be self-supporting but would have had other financial commitments (usually familial) that would prevent them or their friends from
contributing to their upkeep. After 1879, Toronto attracted more paying patients and consequently the percentage of state-supported patients decreased. In the 1870s, 60.3 percent of the patients were supported but in the 1880sthis had decreased to 47.8 percent. By the 1890s
the number of non-paying patients had increased to 63.8 percent of
those admitted which, while high, was much less than the 80 percent
characteristic of the 1850s and 1860s. Any reduction in non-paying
patients corresponded to a reduction in the number entering through
warrants, for the tendency was for warrant patients to be non-paying.
This was certainly the case in the 1880s. In 1885, 91 patients entered
through a private medical certificate and only 25 entered through a
warrant.2gThere were, of course, ways around this. If a family wanted
one of their relatives to be accepted at the Toronto asylum they could
commit them as a paying patient. Eventually they could reduce their
payments, arguing financial constraints, and all that would happen
would be a transfer of the individual to the free ward. Once in the
asylum it was difficult to move a patient to another asylum without the
permission of his or her friends.30
Women tended to be paying patients more than men but the difference was not significant. Of the female patients 37.2 percent paid
whereas for the males it was 33.5 percent. This may have been linked to
marital status; 50.1 percent of those paid for by the state were single
whereas only 44.2 percent were married. Because more women patients were married than men patients this would result in more
women paying. Married women, as opposed to single or widowed,
would have had husbands who could possibly support them. A married man, on the other hand, if incarcerated, left his family with few
financial resources with which to pay for his stay in the asylum.
MARITAL STATUS
Marital status clearly was a factor of some importance. It partially
determined how an individual entered the asylum and whether he or
she paid or not. It was also significant in determining the sex of the
patient, and this puzzled the superintendents of several asylums,
leading them to explanations which reflected their own personal perceptions of gender identity. Patients in the asylum were evenly divided
between married and single patients, with 46.4 percent married, 46.9
percent single and 6.6 percent widowed or deserted. The interesting
aspect, however, was the gender of each. Throughout the century
married women outnumbered the single and single men outnumbered
the married. For example, from 1841 to 1875, there had been 1,339
106
l
WENDY MITCHINSON
married or widowed women compared to only 730 single women and
1,055 married or widowed men compared to 1,277 single men.31
Throughout the century, 41.6 percent of the men admitted were married, 54.0 percent were single, and 4.4 percent were widowed. For
women, 51.4 percent were married, 39.7 percent were single, and 8.9
percent were widowed. This is a significant difference.
It is perhaps understandable that women experienced a higher rate
of widowhood than men since they did live longer but how were the
other differences to be accounted for? There was a reluctance on the
part of asylum superintendents to admit that marriage was healthy for
a man and not for a woman and so other explanations were sought. In
his 1858report, Workman noted the fact that married women outnumbered the single and tried to account for it by arguing that "Women
marry at an earlier age than men; insanity finds the latter, to a large
extent, in the state of celibacy, and the former in the married state.
Were all women sure of getting good husbands, we might have no
hesitation in advising them, if they requirkd any suggestion. . . to
exchange single discomfort for married bliss."32Thus married women
outnumbered married men because they married younger and so there
would simply be more of them in the younger age range. Thus Workman was sensitive to the particular demographic or life-cycle experience of women. Also, it was admitted that some of these women did
not marry "good husbands. Despite this latter point, in his 1859report
Workman still maintained that in general marriage was conducive to
sanity.33To account for the discrepancy between the sexes he introduced a new explanation. Single men masturbated more than married
men and he felt this could lead to an incurable form of insanity.34The
next year, when the statistics seemed to reverse themselves, i.e., when
the numbers of single men and married women fell below average, he
felt compelled to admit that "This variation may be purely accidental,
and no proof of improved morals in the former, or in the husbands of
the latter."36 By 1862 he again is trying to explain the large number of
married women admitted to the asylum.
Women are unavoidably the subjects of numerous impairing and disturbing
agencies, both physical and mental, from which men are exempt. Gestation,
parturition, lactation, uterine disorder, want of sleep, defective nourishment,
bad air, and C., and c. [sic], may be instanced in the former; and drunken
husbands in the latter.36
The particular physical stresses that women experienced were acknowledged with sympathy. The problems surrounding childbirth
perhaps suggested a physical weakness on the part of women but want
of sleep, defective nourishment, and bad air were clearly aspects of
their lives which were social in origin. In mentioning them and reiterating the problems of poor husbands, Workman underlined the harsh
Gender and Insanity as Characteristics of the Insane
107
reality of many married women's lives. Yet he had difficulty accepting
that much of this harshness was linked to the institution of marriage as
then practiced.
In the 1864 Canada Medical Journal, Workman made another attempt
to address the discrepancy between admissions of married women and
men. He argued that the greater number of married women over single
and single men over married in asylums evened out when the proportions in the general population were considered, and indeed when
they were taken into account single women were over-represented in
the asylum.37However, it would appear that he was using incorrect
data. For instance, he claimed that in the 1861 census the 30- to 40year-old age group was divided as follows:38
Men
Women
Married. ........ 113,653
Single .......... 144,001
Married ......... 133,544
Single .......... 58,254
In fact, the figures from the census indicate that the following was the
correct division for Upper Canada:39
Men
Women
Married ......... 65,813
Single .......... 16,757
Widowed ....... 1,605
Married ......... 61,403
Single .......... 9,519
Widowed ....... 3,087
Working with the correct statistics leaves no over-representation of
single women in the asylum between the ages of 30 and 40. On the
other hand, there is no under-representation either. But there is overrepresentation of married women, with a predictive figure of 682
married women when the actual figure in the asylum was 950.
Workman may have realized his mistake for he never used that
argument again and returned to his earlier points. In 1873he made one
of his last statements on the phenomenon. "It would seem that, as far
as liability to insanity is concerned, marriage is very dangerous to
women and single life very dangerous to men, whilst married men and
single women enjoy comparative immunity."40 While Workman left
the issue there, other asylum officials continued the attempt to explain
the d i ~ c r e p a n c yDr.
. ~ ~Hobbs, surgeon in charge of the London asylum, in the 1899 Dominion Medical Monthly reiterated some of Workman's earlier points. Masturbation accounted for the high percentage
of single men in the asylum and the physical pressures of childbirth
accounted for the high representation of married women.42
The opinions expressed by Workman and others revealed much
about late nineteenth-century attitudes towards women. They reflected a sensitivity to the problems associated with childbirth and the
strain under which they placed women. However, the recognition of
108
WENDY MITCHINSON
those problems implicitly underscored another belief-women were
the weaker sex, not through any fault of their own but because of their
very nature. When non-biological problems associated with marriage
were listed, Workman made no attempt to offer remedies. Women
perhaps could not avoid childbirth, but surely some attempt could be
made to ensure that they were given enough food, had access to fresh
air, and had their burdens lifted so that they could get enough sleep.
Workman seemed to accept these as an inevitable part of marriage
without suggesting that they bore more heavily on the wife than on the
husband. The structure of marriage was natural and proper and should
not be tampered with. Consequently, although Workman was sensitive to problems facing women who were married, he did not see any
remedy for them. Certainly, avoidance of marriage was no solution. As
the situation of single men pointed out, if women did not marry they
would be open to the threat of insanity through masturbation.
AGE OF ASYLUM PATIENTS
l
While the marital status of insane patients may have troubled asylum
superintendents, the age profile did not. Most patients were in their
middle years. The ages of greatest concentration were the twenties, at
32.2 percent, the thirties, at 26.8 percent, and the forties, at 18.7
percent. These were the years when the pressures to establish oneself
economically were the greatest. In addition, there would be added
societal pressures to conform in this age grouping, whereas some
latitude of behavior was possible for the very young and the very old. If
deviancy emerged in the middle years it would be seen as abnormal
and in need of treatment. Although most patients were between the
ages of 20 and 50, Clark noted that by the end of the century, increasing
numbers of patients were elderly and the asylum was being used as an
old age home. Some of these individuals did not belong in an asylum
for they were not insane.43These patients give credence to the custodial and non-curative aspects of the asylum to which many historians
have pointed. Even more, the asylum was being used as a welfare
establishment. However, this should not be exaggerated. Throughout
the nineteenth century, only 5.9 percent of the patients admitted were
over the age of 60. However, Clark was sensitive to a trend, for when
age of patients admitted is examined over time there is a continuous
increase in the elderly. Of the 851 patients for whom the age on
admission was noted, 36 percent of those over the age of 60 were
admitted in the 1890s, whereas in the 1860s and 1870s the percentages
were 12 and 14 respectively (see Table 2). It should be noted that the
numbers involved are small, distorting the percentage calculations,
but nevertheless the trend to increased admittance of the elderly is
evident.
Gender and Insanity as Characteristics of the Insane
Table 2
Year of Admission by Age of Patient
Decade
Up to 20 20 to 30 30 to 40 40 to 50 50 to 60 60 plus
Column
Totals
I
Row
Totals
62
7.2%
aN~mber
bExpectedvalue
'Row percentage
dColumnpercentage
Over the century, there was no difference between the average age
of men and women. For both it was 36 years. Women were more
numerous in the 30- to 40-year-old age range, perhaps because of the
pressures of marriage. Elderly women outnumbered elderly men but
this is to be expected given their longer life expectancy. However, their
numbers were increasing. The elderly women entering in the 1890s
represented 44.8 percent of the elderly women committed over the
1841-1900period and were14.6 percent of the total women who entered
in that decade (see Table 3B).44
WENDY MITCHINSON
Table 3A
Year of Admission by Age of Male Patients
30 to 40 40 to 50 50 to 60 60 plus
Decade
Column
Totals
I
31
7.5%
143
34.7%
Row
Totals
17
15.2
26.6%
17.3%
14
12.0
21.9%
18.2%
2
6.5
3.1%
4.B0/o
0
3.3
.O%
.O%
64
15.5%
19
15.7
28.8%
19.4%
10
12.3
15.2%
13.0%
7
6.7
10.6%
16.7%
3
3.4
4.5%
14.3%
66
16.0%
10
14.3
16.7%
10.2%
12
11.2
20.0%
15.6%
7
6.1
11.790
16.7%
2
3.1
3.3%
9.5%
60
14.6%
18
18.3
23.4%
18.4%
11
14.4
14.3%
14.3%
6
7.8
7.8%
14.3%
5
3.9
6.5%
23.8%
77
18.7%
11
15.9
16.4%
11.2%
15
12.5
22.4%
19.5%
10
6.8
14.9%
23.8%
6
3.4
9.0%
28.6%
67
16.3%
23
18.6
29.5%
23.5%
15
14.6
19.2%
19.5%
10
8.0
12.8%
23.8%
5
4.0
6.4%
23.8%
78
18.9%
98
23.8%
77
18.7%
42
10.2%
21
5.1%
412
100.0%
aNumber
bExpected value
'Row percentage
dColumn percentage
As with age, the ethnicity of the patients held few surprises. There
was no real difference between the sexes, although 62.2 percent of
those born in the United States were female whereas only 51.6 percent
of the Toronto asylum sample population were female. This was probably due to American women marrying Canadians and leaving the
United States. Seldom would American men marry Canadian women
and move to Canada. Immigrants dominated the early decades, and
even by the end of the century they were still over-represented compared to the Canadian-born. This probably reflected the problems of
adjustment that they faced, their lower economic standing, and con-
Gender and Insanity as Characteristics of the Insane
111
sequently their inability to care for their insane in their homes. However, it should be noted that although the Irish were by far the largest
group in the 1840s, representing 43.3 percent of the patients, by the
1850s the other British groups had collectively become the most
numerous in the asylum. As would be expected, Canadian-born patients dominated with the passage of time.
No correlation existed between sex and religion and only a slight one
for education. As could be predicted, women were not highly educated
but neither were they illiterate. Of those patients experiencing no
education 46.2 percent were women and 53.8 percent were men. Thus
Table 3B
Year of Admission by Age of Female Patients
Age
Up to 20 20 to 30 30 to 40 40 to 50 50 to 60 60 plus
Decade
1840s
l
Row
Totals
3a
2Ab
7.5%C
9.7%d
1850s
9
5.4
11.8%
29.0%
1860s
6
4.9
8.6%
19.4%
1870s
3
5.4
3.9%
9.7%
1880s
3
6.2
3.4%
9.7%
1890s
7
6.3
7.9%
22.6%
Column
Totals
31
7.1%
aNumber
bExpected value
cRow percentage
dColumn percentage
29.8%
29.6%
18.7%
8.2%
6.6%
100.0%
112
WENDY MITCHINSON
women were more likely than men to have had some education. Over
time, the educational ability of the patients increased significantly (see
Table 4). Thus according to the patients admitted, the Toronto asylum
was not a place for the "losers" of society. This is partially a function
of the fact that in the latter years of the century the Toronto asylum
increasingly admitted paying patients.
Table 4
Year of Admission by Education of Patient
Education
Decade
Limited
Column
Totals
aNumber
bExpectedvalue
cRow percentage
dColumn percentage
Fair
Good
Row
Totals
Gender and Insanity as Characteristics of the Insane
113
The occupational profile of the patients also supports the hypothesis
that the asylum was not a place for "losers." In much of the social
control literature the asylum is seen as a place of containment for the
idle, yet when occupations are examined this contention is not supported; the vast majority of patients had occupations, although there is
never any firm indication of whether they were presently engaged in
them. The largest groups were farmers (13.0 percent), laborers (10.3
percent), and domestics (11.8 percent). Other than stating the obvious,
that women dominated the domestic category, no other conclusions
about occupation and gender can be drawn. There was no consistency
about the occupational descriptions of the female insane. Sometimes
the woman's occupation was ignored; if married, the occupation of her
husband might be listed, but inconsistently; and more often than not
no distinction was made between wife and domestic servant. Despite
these complications, it is evident that most people in the asylum had
had an occupation. They were not viewed by those admitting them as
idle.
Three more categories were examined in an effort to discern any
gender differences in those committed to the asylum. The first was the
existence of previous attacks of insanity or previous admission to an
asylum. Previous attacks were quite strong among both sexes, occurring in 40 percent of the men and 45 percent of the women. This
indicates that for many of the patients there was a history of illness
before committal. Eighteen percent of the men had been in an asylum
before and 22 percent of the women had been incarcerated. When it is
remembered that these figures are conservative estimates, it is clear
that previous admission was a strong variable determining incarceration of the insane.
The second factor examined was length of illness before committal.
Superintendents constantly reiterated that an early committal would
lead to a cure but a late one would delay if not prevent one, and
bemoaned the fact that early committals were not the rule.45Seventyfour percent of the patients for whom information is available were ill
for less than one year before admission. Families were not keeping
their insane relatives from entering asylums despite what Workman
and Clark were saying. There was no real difference between the two
sexes; 81.1 percent of the women were admitted after less than one
year's illness and 80.6 percent of the men. If marital status is examined
78.9 percent of the married entered the asylum with less than one
year's illness but only 68.8 percent of the single. Does this mean that
illness among the married was more disruptive to family life leading to
incarceration or does it mean the insane with families were incarcerated more quickly because their families cared? Whatever the reason,
the larger percentage of married people would mean a slight numerical
superiority in women patients entering after a brief illness.
114
WENDY MITCHINSON
Certainly the existence of some family member in well over 80
percent of cases (both male and female) is a variable that has to be
considered. Thus patients were not alone and the asylum was not
incarcerating people with no support in society.46What is interesting
about the written case histories is that often the husband is mentioned
more than the wife. It appears that many physicians took their depositions from the husbands of insane women but preferred to take depositions from male relatives of insane men. The presence of families, of
course, should not be taken as a necessarily positive feature. For
Margaret D. (4950) the asylum appeared as a refuge where someone
would take care of her and where no one would be able to hurt her.
Margaret H. (5300), whose husband beat her, would also see the
asylum as a haven, as would Emily T. (6400), who was strapped down
at home.
INTERPRETATIONS
I
When the patients of the Toronto asylum are examined, several refinements to previous theories of asylum incarceration are demanded.
There is no indication that the asylum was used as a place for the
containment of the idle, as suggested by many proponents of social
-4
control. The only way this could be argued is on the basis that once a
, person was insane they would be unable to work. The records do not
3uggest this, and if it is a given and not worthy of mention in the
records the question becomes, why should historians make such an
- ,issue of it? For nineteenth-century physicians, the inability or unwillingness of the insane to work was a consequence of their disease and it
was their disease that demanded incarceration, not their idleness.
* The age profile of the patients also suggests that the asylum was not
being used as an institution of control over the young. However, the
number of elderly did increase in the latter part of the century, revealing a tendency for the asylum to become increasingly custodial since
these patients were more than likely not going to be cured and released.
When gender differences are examined some strong similarities and
differencesemerge. Differences between male and female patients on
the basis of age and religion do not exist. Differencesbased on education and ethnicity were minor and were ones that were to be expected.
In addition, there was no difference in how quickly a man or a woman
was incarcerated, whether they had had a previous attack or admission, or whether they had family nearby.
However, differences between patients on the basis of sex did exist.
,Women tended to enter the asylum through family committal as opposed to the warrant system. This suggested the reluctance of families
to incarcerate their male insane and a difference in the symptoms of
Gender and Insanity as Characteristics of the Insane
115
insanity exhibited by the two sexes. Not unexpectedly, women more
than men paid for their stay in the asylum. This reflected the existence
of husbands or other family members who could pay for them.
The most interesting aspect of the personal characteristics of the
insane based on gender was marital status. It was the one that intrigued Superintendent Workman the most, and he spent considerable
effort trying to explain the preponderance of married women and
single men. His efforts emphasized the importance of marriage in the
mid-nineteenth-century lexicon and the total unwillingness to see it as
an institution of benefit for one sex more than the other; thus other
explanations for the preponderance of married women had to be
sought. Those explanations revealed popular attitudes on a variety of
subjects, a prime one being the lack of self control of men in sexual
matters and the consequent dangers of masturbation. Workman's
theories also suggested that women's bodies simply broke down under
stress and that consequently they were the weaker sex. This could and
did lead to sex-specific treatment in several Canadian asylums.47
Nevertheless, Workman's focus on the problems concomitant with
childbirth, the difficulties women (particularly married ones) had in
obtaining proper nourishment, and their vulnerability to " b a d husbands revealed a sensitivity to the plight of women. It was not just their
bodies which caused them to break down mentally. It was their position in society and the way in which marriages were experienced by so
many women. Although Workman never suggested any ways that
women might avoid these difficulties, he at least was aware of them,
for which his women patients must have been grateful. In this light,
the care meted out in the asylum made sense. Nourishing food, exercise, and fresh air were stressed. The asylum could not cure the female
insane but it could provide the atmosphere in which some could cure
themselves. That was the underlying philosophy of moral treatment.
l
NOTES
* Financial assistance for the research of this paper was provided by the Social
Sciences and Humanities Research Council and the Hannah Institute for the History
of Medicine.
1 The major social control arguments are to be found in the following:Stanley Cohen
and Andrew Scull, eds., Social Control and the State (Oxford:Robertson, 1983);Michel
Foucault, Madness and Civilization: A Histo y of Insanity in the Ageof Reason (New York:
Pantheon Books, 1965); Christopher Lasch, "Origins of the Asylum," in C. Lasch,
The World of Nations (New York: Knopf, 1974), p. 3-17; David Rothman, The Discovey
of the Asylum (Toronto: Little, Brown & Co., 197l); David Rothman, Conscience and
Convenience: The Asylum and its Alternatives in Progressive America (Boston: Little,
Brown & Co., 1981); Andrew Scull, ed., Madhouses, Mad-Doctors, and Madmen: The
Social Histoy of Psychiaty in the Victorian Era (Philadelphia: University of Pennsylvania Press, 1981); Andrew Scull, Museums of Madness: The Social Organization of
lnsanity in Nineteenth Centu y England (London: St. Martin's Press, 1979).
116
WENDY MITCHINSON
See Thomas E. Brown, "The Origins of the Asylum in Upper Canada, 1830-1839,"
Canadian Bulletin of Medical History, 1(1984): 27-58; Richard Fox, So Far Disordered in
Mind: Insanity in California, 1870-1930 (Berkeley:University of California Press, 1978);
Harvey Simmons, From Asylum to Welfare (Downsview: National Institute on Mental
Retardation, 1982); Nancy Tomes, A Generous Confidence; Thomas Sto ry Kirkbridge and
the Art of Asylum-Keeping, 1840-1883 (London: Cambridge University Press, 1984).
Franz Alexander and Sheldon Selesnick, The Histo y of Psychiatry: An Evaluation of
Psychiatric Thought and Practice from Prehistoric Times to the Present (New York: Harper
& Row, 1966), p. 5.
Annual Report of the Inspector (ARI) 1874, Ontario Sessional Papers (OSP), no. 2
(1875, second session): 6-7.
Annual Report of the Medical Superintendent, Toronto (ARMS) 1883, OSP, no. 8
(1884): 63. By 1893, however, the Inspector is stating that 40 percent of the insane
remained outside of the asylum system. ARI 1893, OSP, no. 26 (1894): xii.
The records were examined to determine the personal characteristics of the
insane-age, sex, ethnicity, religion, occupation, etc. These were thencodedfor the
computer. The program used was SPSSX.
See W. Mitchinson, "Committal to Mid-Nineteenth-Century Asylum: Symptoms of
Insanity, the Case of Toronto," in Essays in Canadian Medical History, ed. W. Mitchinson and J. Dickin McGinnis (Toronto: McClelland & Stewart, in press).
For a history of the PLA see Thomas Brown, "Living with God's Afflicted: A History
of the Provincial Lunatic Asylum at Toronto, 1830-1911," PhD thesis, Queen's
University, 1982; Henry Hurd et al., The Institutional Care of the Insane in the United
States and Canada (Baltimore: Johns Hopkins Press, 1917); Montreal Medical ]ournal, 34
(1905): 399-430; Henry Stalwick, "A History of Asylum Administration in PreConfederation Canada," PhD thesis, University of Western Ontario, 1969.
Ranier Baehre, "Joseph Workman (1805-1894) and Lunacy Reform: Humanitarian or
Moral Entrepreneur," paper presented at the Annual Meeting of the Canadian
Historical Association, 26 June 1980; American ]ournal of Insanity, 24 (1867): 44-45.
Montreal Medical ]ournal, 34 (1905): 403.
Hurd, The Institutional Care of the Insane, vol. 4, p. 195.
Annual Report of the Directors, Appendix C, ]ournals of the Legislative Assembly (]LA)
1851.
ARMS 1899, OSP, no. 34 (1899): 50.
Elaine Showalter, "Victorian Women and Insanity," in Madhouses, Mad-Doctors,
Madmen: The Social History of Psychiatry in the Victorian Era, ed. Andrew Scull
(Philadelphia: University of Pennsylvania Press, 1981), p. 316.
Statistical Year Book of Canada (Ottawa: Department of Agriculture, 1896), 411.
ARMS 1899, OSP, no. 34 (1900): 50. These percentages are based on total admissions.
In my sampling the figures were almost reversed, i.e., 48.6 percent of the patients
were male and 51.4 percent were female.
Canada Medical ]ournal, 1(1864): 401.
Statutes of the Province of Canada 1852153, 928-29. In 1871 the physicians were
required to visit the insane separately and not collectively. In 1882only two doctors'
certificates were demanded.
Appendix J, ]LA 1852153; Appendix 2, ]LA 1856; ARMS 1863, Sessional Papers
No. 39, Appendix, ]LA 1864; ARMS 1862, Sessional Papers No. 66, ]LA 1863.
36 Vict. 1873 Cap. 31, Statutes of the Province of Ontario (Statutes) 1873, 96-97; Simmons, From Asylum to Welfare, p. 40.
Statutes 1873, 99.
ARMS 1858, Appendix 11, ]LA 1859.
ARI 1879, OSP, no. 8 (1880): 29.
ARMS 1899, OSP, no. 34 (1899): 53.
]LA 1856.
ARI 1874, OSP, no. 2 (1874): 3.
27 ARI 1888, OSP, no. 1 (1889): 35.
Gender and lnsanity as Characteristics of the Insane
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
ARI 1888, OSP, no. 1(1889): 51.
ARMS 1885, OSP, no. 2 (1886): 41.
See patients 8550 and 6620.
ARMS 1875, OSP, no. 4 (1875): Zl3.
ARMS 1858, Appendix 11, ]LA 1859.
ARMS 1859, Appendix 32, ]LA 1860, 47.
ARMS 1859, Appendix 32, ]LA 1860,47; ARMS 1862, Sessional Paper 66, ]LA 1863.
ARMS 1860, Appendix 24, ]LA 1861.
ARMS 1862, Sessional Paper 66, ]LA 1863.
Canada Medical lournal, 1(1864): 406-407.
Canada Medical journal, 1(1864): 406.
Census 1665 to 1871 (Ottawa, 1876), 263.
ARMS 1873, OSP, no. 2 (1874): 160.
See R. M. Bucke Collection, A9, p. 2, University of Western Ontario, for opinions
expressed by the Superintendentof the London Asylum, Dr. R. M. Bucke. See also
Canada Lancet, 37 (1903): 306, for Dr. Emest Hall's opinion. Hall was much involved
with the asylum in British Columbia.
Dominion Medical Monthly, 13 (1899): 179.
ARMS 1897, OSP, no. 10 (1897198): 3-4.
Note that the numbers from the sample for the elderly are very small.
ARMS 1858, Appendix 11,jLA 1859; ARMS 1850, Appendix C, ]LA 1851; ARMS 1852,
]LA 1852153; ARMS 1864, Sessional Paper No. 14, ]LA 1865,110; ARMS 1876, OSP,
no. 2 (1877): 206; ARI 1887, OSP, no. 13 (1888): 27.
An additional 15 percent of the patients had family but were having problems with
them.
At the London asylum, gynecological surgery was performed on insane women in
an effort to cure their insanity. Dr. Emest Hall in British Columbia performed similar
surgery. And at the Kingston asylum the menstrual cycle of women was a major
focus resulting in ovarian extract being given to many women patients.