Research is addictive. It’s a lot like writing, taking you on a journey far beyond where you imagined you would go. Researching Elizabeth Alcott’s life is taking me on that unexpected journey. In the next few posts, I will take you there too, into the world of nineteenth century women’s health issues.
Just a note that I am just learning about these things and would very much appreciate your comments as I know many of you know far more than I do!
Lizzie’s diagnosis
In Transcendental Wife, Cynthia Barton writes of the doctor’s final diagnosis of Lizzie’s illness: “atrophy or consumption of the nervous system, with great development of hysteria.” (pg. 161, excerpt taken from Abba’s journal in January of 1858). What in the world does that mean?
The root of a woman’s ills
To understand this diagnosis, one needs to know the foundation for all diagnoses of women’s ailments: “medical analysis of a woman began and ended with consideration of an organ unique to her, namely her uterus.” (from Women and Health in America, First Edition, edited by Judith Walzer Leavitt, from the article, “The Fashionable Diseases”: Women’s Complaints and Their Treatment in Nineteenth-Century America” by Ann Douglas Wood). (pg. 223)
It was supposed that women were subjected to twice the number of diseases as men simply because they have a womb. A certain Dr. Dewees, professor of midwifery at the University of Pennsylvania wrote, “Her uterus exercises a ‘paramount power’ over her physical and moral system, and its sway is ‘no less whimsical than potent.’ Furthermore, ‘she is constantly liable to irregularities in her menstrua, and menaced severely by their consequences.” (pg. 224)
Therefore, the root of Lizzie Alcott’s illness according to Dr. Christian Geist (a well-known practitioner of homeopathy), was her uterus.
It’s no wonder Dr. Geist came up with his diagnosis considering the symptoms commonly attributed to the uterus: loss of weight, peevish irritability, hysterical fits of crying and insomnia, constipation, indigestion, headaches and backaches. (ibid)
Prescribed treatment of hysteria (be forewarned!)
Treatment was “local,” beginning with an internal investigation of the womb. When Lizzie was examined by Dr. Geist, it was likely she was put through such an internal. Wood writes that it did not matter whether or not the symptoms were directly related to the uterus: “her uterus might well be subjected to local treatment in the period 1830-1860.” (“The Fashionable Diseases,” pg. 224) Cynthia Barton writes that Lizzie “was, in fact, much agitated by the doctor’s presence and wept all the time he was there.” (Transcendental Wife, pg. 161).
The internal was just the first step in treating hysteria. There were three other stages though not all were applied each time: (warning—this may make for difficult reading)
- Manual investigation
- “Leeching” (actual leeches attached)
- “Injections” (of a variety of elements including water, milk, linseed tea, etc.—you get the idea)
- “Cauterization” (application of nitrate of silver, hydrate of potassa, or the use of a white-hot instrument) (“The Fashionable Diseases,” ibid)
Did Lizzie receive this treatment?
Dr. Geist’s diagnosis of hysteria was made in January of 1858; Lizzie died in March of that year. She was a mere 84-1/2 pounds when he saw her (from Lizzie’s letter to Bronson, December 13, 1857, Houghton Library MS Am 1130.9 (25-27) and MS AM 2745 (71)). There is no mention in family journals or letters of any followup from Dr. Geist’s initial visit. I would speculate that Abba, utterly committed to homeopathic medicine (and also very doubtful of the benefits of medicine–see below), wanted to spare Lizzie the suffering that would come of such treatment.
Like a B-grade horror movie!
As a complete novice to women’s health issues and their treatment in the nineteenth century, I was greatly disturbed; reading Ann Douglas Wood’s essay was like watching a gruesome horror movie. I could not comprehend how supposedly educated men calling themselves doctors actually bought into such a line of thinking–to me it defies logic. Medicine was indeed at a primitive stage often inflicting more pain than it cured. It is no wonder that Abba, exasperated at one point at the failure of doctors to even reach a diagnosis, called the whole medical process “a prolonged Guess.” (from Abba’s letter to brother Sam, August 25, 1857, MS Am 1130.9 (25)).
Abba’s letter to brother Sam, August 25, 1857, MS Am 1130.9 (25), Houghton Library, Harvard University
In many ways, the guessing game exists today as well, especially when it comes to mental health. I recently watched a video of a presentation by Debbie Nathan, author of Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case (proving that the multiple personalities were faked) where she documented the experimental drug use that patients endured from their psychiatrists; it sounded as crazy as the treatment nineteenth century women received for their ills. Are things really that much better today? It’s hard to say. I would venture to say there is still a lot of guessing in medicine.
Exploring other health issues
In briefly exploring hysteria, I then thought about PMS and puberty. What would puberty have been like for the Alcott girls? Louisa gives us a taste of hers in her journal which I will explore in the next post. Women and Health in America featured two essays about menstruation and puberty for young women during Louisa’s time and I will share a summary of those articles.
And again, if you are knowledgeable about women and health in Louisa’s time, please chime in!
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