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Authors: Kate Summerscale

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In
Mr Nightingale’s Diary
, a one-act farce set in a water-cure spa, Charles Dickens and his friend Mark Lemon explored the idea that a journal could pander to and promote its writer’s fantasies. Dickens was inspired to write the piece after accompanying his wife to the celebrated hydropathic establishment at Malvern in 1851 (Catherine was ‘seriously ill with some kind of nervous trouble’, he wrote). The play was staged before the Queen and the Prince Consort in Piccadilly that May, with Dickens, Lemon, Wilkie Collins and the painter Augustus Egg among the cast.

Mr Nightingale hides a real secret in his diary – he is paying his wife to pretend to be dead – but most of his entries record anxieties about his body. The play parodied the fashion for self-diagnostic ‘diaries of health’. ‘Dyspeptic’, runs one entry. ‘Feel as if kitten at play within me.’ By dwelling on his body, Mr Nightingale has riddled it with imagined sicknesses, acquiring a morbid sensitivity to every twinge and shiver, much as keeping a diary encouraged Isabella to interpret every detail of others’ behaviour in the light of her own preoccupations. ‘You
are
ill, if you only knew it,’ he tells a servant at the hydropathy spa. ‘If you were as intimate with your own interior as I am with mine, your hair would stand on end.’

Mr Nightingale describes the diary as his ‘only comfort’, but it has become a symptom of his sickness, even a cause. When it is stolen and read by others, the journal betrays him: instead of helping him to look into himself, it enables others to read him; instead of cleansing him of his sin, it delivers him up for punishment. Its passivity is an illusion. At the end of the play Mr Nightingale is given the advice: ‘Burn that book, and be happy!’

See Notes on Chapter 9

10
An insane tenderness

Westminster Hall, 15 June 1858

At lunchtime the judges withdrew for refreshment – typically a meat chop and a glass of sherry – and then took up their places on the bench for the afternoon.

Dr Phillimore, having raised the possibility that parts of Isabella’s diary were fictional, still needed to explain to the court what had driven her to invent such degrading scenes. He told the judges that the journal was the product of uterine disease.

‘I will be able to prove,’ said Phillimore, ‘that it is a characteristic of this disease that it produces sexual delusions of a most extravagant character’, making a woman ‘suppose herself guilty of the most horrible, and, indeed, the most impossible crimes’. The illness, he said, sometimes arose from a pressure on the brain, sometimes from malfunction in the uterus itself. To establish this, he said, he would call a number of medical witnesses.

Joseph Kidd was sworn. He was an Irish Quaker, tall, fine-featured and blue-eyed, who had been admitted a Fellow of the Royal College of Surgeons in 1847 and had taken his medical degree at Aberdeen in 1853. No mention was made in court of the unconventional branch of medicine in which
he had trained: he was a homeopathic doctor, like John Drysdale, and had returned to Ireland in 1847, during the Great Hunger, to try to alleviate his countrymen’s suffering with his alternative remedies. When Isabella had first consulted Dr Kidd in Blackheath, he had been twenty-five years old. He was her type: young, handsome, clever, idealistic, open to new ideas.

Kidd testified that Mrs Robinson had been his patient between 1849 and 1856, especially 1849 and the three or four years after that. In 1849, he said, he had treated her for a disorder of the womb. He based his diagnosis on the headaches, depression and irregular menstruation that she suffered after Stanley’s birth, all of which he believed to be manifestations of post-natal uterine disease.

Kidd was asked to describe Mrs Robinson’s temperament.

‘Her general tendency was a morbid excitement,’ he said, an allusion to Isabella’s heightened sexuality. ‘I regarded her as of a naturally morbid and depressed condition. Her mind alternated between excitement and depression.’

Might her uterine disease have produced such symptoms? asked Phillimore.

‘I did not refer them to it at the time,’ said Kidd, ‘but from the statements in the diary, I think they might be attributed to this cause.’

Phillimore asked Kidd whether he was prepared to state that Mrs Robinson had suffered from nymphomania or erotomania since 1852.

He could not testify to that, he said, as she had not been so directly his patient during this period.

Phillimore dismissed Kidd and proceeded to call three more physicians as witnesses. Their task was to confirm that uterine disease, the condition that Kidd had diagnosed, could cause erotomania or nymphomania, the conditions from which Isabella’s counsel claimed that she was suffering.

The first of the specialists was James Henry Bennet,
forty-one, a cherubic man with lustrous eyes and luxuriant black hair. Dr Bennet, of the Royal Free Hospital in London, represented the modern school of gynaecology. He was an authority on uterine inflammation and a pioneer of vaginal examination with a speculum – a practice from which most doctors then recoiled. The speculum was controversial, in part, because of the possibility that its use might excite female patients.

The second was Sir Charles Locock, fifty-nine, a slight, grey-haired man with a dry, decisive manner. Having been Queen Victoria’s obstetrician since 1840, Dr Locock was granted a baronetcy in 1857 after delivering her ninth child. He was the author of nearly all of the entries on female disease in the standard manual
The Cyclopaedia of Practical Medicine
, and he took a particular interest in hypersexuality. Like Bennet, he was an advocate of the speculum. He had experience as a medical witness: in 1854 he was asked by the Consistory Court at Doctors’ Commons to conduct a physical examination of Euphemia Ruskin who, after six years as the wife of the celebrated art critic John Ruskin, had petitioned for an annulment on the grounds that her marriage had never been consummated. Locock had confirmed to the judge that Mrs Ruskin was a virgin.

The last medical witness for Isabella’s defence was Benignus Forbes Winslow, aged forty-seven, an alienist and asylum keeper. As the founder and editor of the
Journal of Psychological Medicine and Mental Pathology
, he was a well-known and combative pioneer of the mental sciences. Dr Forbes Winslow, shiny-pated and self-assured, had appeared as one of Alexander Cockburn’s expert witnesses in the M’Naghten trial and his publications included a defence of the insanity plea.

The judges ordered the court to be cleared of women during the medical evidence, and most newspapers did not repeat the ensuing testimony –
The Times
pronounced it
‘obviously not of a fit nature for a detailed report’. Even the fullest account, in a legal digest published in 1860, provided only a sketch: Bennet, Locock and Forbes Winslow testified that uterine disease could give rise to a ‘morbid condition of the mind on sexual subjects’, provoking women to accuse themselves, ‘without the slightest foundation, of the most flagrant acts of unchastity’. They said that it was common for such women to have ‘strong and extravagant mental delusions’ about sex while remaining perfectly sane on all other subjects. After hearing the doctors’ testimony, Cockburn adjourned the case until the following day.

Though the press reported sparingly on the physicians’ evidence, the medical literature of the time expounded in detail the conditions that they had described.

Gynaecology was a new specialism, and the diagnosis of ‘uterine disease’ encompassed all manner of female complaints, emotional and physical. Since a woman’s reproductive system was believed to exert a strong influence on her mental health, a gynaecological disorder implied mental illness, and vice versa – about ten per cent of sufferers from uterine disease were said to end up in asylums. Any change in a woman’s sexual or reproductive life was seen as an opportunity for emotional derangements such as the sexual mania attributed to Isabella. After giving birth, wrote Dr Bennet, a woman usually lost all erotic appetite, but ‘in some exceptional cases, so far from inertia being the result of uterine inflammation, the sexual feelings are exaggerated. Indeed, I have known this exaggeration carried so far as to constitute a kind of nymphomania. When this is the case there is often clitoric enlargement, and its sequela, local irritation.’ Alternatively, the trigger for hysterical nymphomania could be the menopause: the eminent gynaecologist E. J. Tilt (a colleague of Bennet) identified the ‘change of life’, or ‘dodging-time’, as
the most common cause. Forbes Winslow, too, observed that women sometimes experienced erotic mania when they stopped menstruating. Then again, an amative woman could be unbalanced simply by a sudden reduction in the frequency with which she had intercourse: as a result of widowhood, for instance, or a husband’s prolonged absences on business. Tilt argued that ‘sub-acute ovaritis’ (which accounted for a third of uterine diseases) was usually caused by sexual privation. When Euphemia Ruskin petitioned for an annulment of her marriage on the grounds of non-consummation, John Ruskin wanted to justify his reluctance to have intercourse with his wife by bringing the court’s attention to her ‘slight nervous affection of the brain’. His lawyer dissuaded him, pointing out that the court was likely to see Euphemia’s supposed derangement as a result of sexual frustration, rather than a justification for her husband’s distaste.

Female sexual mania took two forms: erotomania and nymphomania. These were distinct illnesses, according to J. E. D. Esquirol’s influential
Mental Maladies: a Treatise on Insanity
: erotomania was a disorder of the brain, while nymphomania had its origin in the reproductive organs. Erotomaniacs, Esquirol wrote, were ‘restless, thoughtful, greatly depressed in mind, agitated, irritable and passionate’. He gave as an example a thirty-two-year-old married woman who developed an obsession with a young man of higher rank than her husband. She suffered from ‘insane tenderness’, nervous pains and changeable moods. ‘She is now, gay and full of laughter; now, melancholic and weeps; and is now angry, in her solitary conversations … She sleeps little, and her rest is troubled by dreams, and even nightmare.’ In her dreams, said Esquirol, she copulated with succubi and incubi, male and female demons.

Nymphomaniacs were less prone than erotomaniacs to mood swings and obsessions, and more given to indiscriminate sexual hunger. The American physician Horatio Storer reported in 1856 on a nymphomaniac patient aged
twenty-four whose much older husband was having difficulty in achieving an erection: she felt overwhelmed with desire every time she met a man. In effect, any woman who reported a powerful impulse to have intercourse with a man other than her husband could be classified as a sexual maniac.

Erotomania and nymphomania were hard to distinguish. ‘The two may exist together,’ noted Daniel H. Tuke in 1857. ‘Patients may most completely exceed the limits of propriety without our having any evidence that the primary disease is in the reproductive organs. It is difficult, in not a few instances, to determine whether the origin of the malady is there, or in the head.’ In any case, it suited Isabella’s counsel to be vague about which of the two conditions afflicted her. They required her to be suffering from symptoms of both: the romantic delusion of the stalker, who imagined that her love was reciprocated, and the lascivious heat of the sex maniac. To accommodate all possibilities, Isabella’s witnesses included a specialist in the brain, Forbes Winslow, and two specialists in the reproductive organs, Locock and Bennet.

The rise in the diagnosis of sexual mania in women corresponded to an intense contemporary anxiety about unsatisfied female desire. It had recently come to light that there was an excess of spinsters in Britain. According to the census of 1851, the country contained half a million more women than men, chiefly because men died younger and migrated more often. For every 100 males, there were 104 females. Older women were especially likely to live alone: forty-two per cent of those aged between forty and sixty were widows or spinsters. The ‘redundant women’ or ‘involuntary nuns’ revealed by the census had become the object of sociological and medical concern. Though Dr William Acton famously announced in 1857 that ‘the majority of women (happily for them) are not very much troubled by sexual feeling of any kind’, many physicians feared that single
women might in fact be driven mad by suppressed and unsatisfied sexual urges.

The treatments for sexual monomania were various. Some physicians, following the phrenologists, targeted the cerebellum: the Scottish alienist Sir Alexander Morison claimed to have cured an erotomaniac governess aged twenty-two by applying leeches to her shaven head, then douching the back of her skull with cold water. Bennet recommended injecting the vagina with a pump syringe, and subjecting the whole body to hip baths, deep baths and showers. Storer suggested that the sufferer should be treated with sponge baths, cold enemas and borax douches, refrain from sexual intercourse and literary pursuits, sleep on mattresses and pillows stuffed with hair, and abstain from meat and brandy. Locock advised the application of electricity to the pelvis of the afflicted woman, or of leeches to her groin, labia, uterus or feet. A London surgeon relieved at least one patient of her sexual feelings by removing her ‘enlarged’ clitoris, an operation reported in
The Lancet
in 1853.

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