Women’s health issues in Alcott’s time: Lizzie’s diagnosis and its repercussions

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

transcendental wife cynthia barton0001In 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

women and health in america first editionTo 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)

matteduterusTherefore, 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)

  1. Manual investigation
  2. “Leeching” (actual leeches attached)
  3. “Injections” (of a variety of elements including water, milk, linseed tea, etc.—you get the idea)
  4. “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)).

prolonged guess letter snippet
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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15 Replies to “Women’s health issues in Alcott’s time: Lizzie’s diagnosis and its repercussions”

  1. Ahh hysteria… the age old disease of unmarried women and educated woman. Poor Lizzie. I’m surprised Louisa didn’t suffer from hysteria. It was believed that if a woman had too much learning her womb might fall out! Hysteria was also supposed to be the cause of kleptomania. Doctors really didn’t know much about the human body at that time.

    1. That’s the understatement of the year! 😉 Last night I watched “American Experience” on PBS about President Garfield’s assassination and how his doctor (Dr. Bliss) botched his care, mainly because of his pride! I mean the arrogance is just incredible. He would not listen to other doctors nor would he even try cleaning the wound to prevent germs – he didn’t like new ideas and thought it risky. Garfield would have lived if that had been done, he died of a massive infection.

      Modesty and the extreme hangups about sex really worked against the safeguarding of people from illness and disease and produced some bizarre ideas.

  2. Hi Susan–This is all really interesting! I’m wondering, do you know for sure that Dr. Geist viewed hysteria as a problem of the womb and that he would have engaged in the treatments you describe, as a practitioner of homeopathy? I need to learn a lot more about this, but it has always seemed to me that homeopathy, as an alternative medicine, approached the body very differently. And a lot of female reformers (including the writer Elizabeth Stuart Phelps) were drawn to homeopathy–perhaps because it treated women differently than traditional medicine. I don’t know for sure but would like to learn more about it.

    1. I am not sure. The book that I referred to, Women and Health in America, and the specific essay by Wood, did not seem to differentiate with regards to homeopathy and the common view of the uterus being the cause of all female ills. Of course it’s always risky to assume but considering Lizzie’s reaction to his visit, it does give me pause. And yes, you are right in the approach to the body being different with homeopathic practitioners (with attention paid to other aspects of the patient besides just the physical, a more holistic approach). I have just begun to dip my toes into this whole area of health issues in the 19th century (last night’s “American Experience” program on the death of President Garfield is fueling the interest all the more). How I wish I could share this with my mom, she was always fascinated with medicine.

      1. Funny–I just shared this with my mom. She is also very interested in medicine and has done research on Civil War medicine and homeopathy. I’ll let you know if she has some insight.

      2. Cool. My mom worked in the Boston city hospitals for several years as a lab technician before marrying my dad and she always maintained in a keen interest in it.

  3. Wow, these findings are really interesting! The business about “hysteria” does not surprise me, however, especially given most 19th c. men’s attitudes toward women. The doctors certainly had a lot to learn about compassion, however, and it’s no wonder to me that the doctor’s mere presence threw Lizzie for a loop. I can imagine that most treatments would have been refused by her, given that she was balking since at least December and the “final diagnosis” was made in January. Again, what a treat it is to have contact with Alcott scholars who can dig all these things out for us. I always did wonder about poor Lizzie. Also, the more I learn, the more I appreciate Mrs. Alcott. She was truly wise and way ahead of her time. (Aside from her blatant dislike of Catholocism.)

    1. She was. Louisa seemed mixed about Catholicism – while she definitely had a problem with the Irish, she included priests in her stories and showed them to be virtuous and strong. I think in particular of the chaste Father Ignatius in “A Long, Fatal Love-Chase” – he obviously loved Rosamond but remained faithful to his vows while helping her all he could.

      1. Commenting further on the article, I often wondered about those girls and how they weathered puberty since I was a “tween” when I first read the book. It’s been said that in those days girls reached puberty a little later on average than in our time. I supposed that Meg was pretty well finished with it, but that Jo was in the throes of it during the story, Beth’s was probably delayed–in the story, at least–due to her illness, and Amy was in a hurry for it but it was still out of reach for her. Perhaps it was that way in real life for the healthy three, and Lizzie, who was still healthy then in real life, probably reached it somewhat uneventfully. It may have, however, been part of the problem when she suffered her marked depression. Notice how her depression was included in the story (Tender Troubles) but as an adjunct to her illness, rather than as ongoing emotional problems, which I think she must have had, at least since the onset of puberty. I think today’s psychologists and psychiatrists would have a field day with her shyness, fears, isolativity, depression and so forth. I was sorry to learn that some people said unkind things about her during her life: that she was sly and used her fears to manipulate the family. I’ll bet such remarks really teed Mrs. Alcott off.

  4. While these treatments do not surprise me, they are none-the-less unsettling. No wonder women of the time were so reluctant to see a doctor.
    I did see part of the PBS American Experience story of Garfield. How horrible that must have been. Are you watching Mercy Street?

    1. I have the episodes saved on DVR – will watch soon. What got me about the Garfield story was the arrogance of Dr. Bliss. His pride was what killed Garfield. And in the reading I’ve done about doctors of the 19th century, this seems to be a prevalent theme. And yet so much of medicine was just as Abba said, a prolonged guess! A lot of blame has been placed on Abba for not seeking medical help sooner for Lizzie (and even when the family came down with small pox years earlier) but I can hardly blame her.

      1. I can’t blame her, either. A cousin of mine once said, when a relation of ours was struggling, waiting for a diagnosis, that it is stilled called “practicing medicine” with doctors engaged in medical practice. I am, however, grateful that we live in the times we do.
        The Mercy Street series is quite graphic, but, still well done.

      2. Oh yes, me too, especially after learning what it was like back then! The next time I yearn for the “good old days” I will remember the dark side.

      3. Wow! Don’t forget, the Alcotts didn’t have much money to pay a doctor, which is probably part of the reason they didn’t consult sooner. Another thing may have been that Lizzie was as secretive as she was able to be, because it would have been “so selfish” to get the family all upset if there was no need. Yes, there are many ailments even nowadays where the doctors can’t come up with a proper diagnosis.

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