Suspecting Insanity: Gender, Sexuality, and the Question 14 (Ontario, 1863-1873)

During the last months of 1863, Joseph Workman, one of the most prominent figures in Canadian psychiatry and medical superintendent at the Toronto Asylum for the Insane from 1853 to 1873 (Johnston, 2000), arrived at the conclusion that asylum admission was poorly regulated. As a strong supporter of the therapeutic goal of the institution, he believed that asylum treatment should target only curable cases of insanity leaving out epileptics, idiots, criminals, and drunkards (Bazar, 2007). Such categories had to be destined to other institutions to be built in the province (Reaume, 2000). Following this ideal, Workman convinced Commissioners of Public Charities to modify the steps for civil confinement. A “Memorandum” dated December 31 1863 recited that: “As it has been found impossible to receive into this Asylum all the insane persons for whose admission application has been made, a By-Law authorising the Medical Superintendent to give preference to cases of insanity of a certain character, has been enacted by the Commissioners and sanctioned by His Excellency the Governor General” (RG 10-268, B296095, Admission N° 2948). As a result of this By-Law, admission files became more conspicuous. To 1853 Forms of Admission it was attached a two-page “Circular” which included a further list of standardized question. Given the influence of its proponent, I will call it “Workman’s Circular”.
This document played an important role in shaping patient admission for the next ten years, until April 11 1873. Particularly, it marked a substantial change in the administration and investigation of lunacy in Ontario during the 1860s. On the administrative side, Workman’s Circular transformed civil confinement into an application process, it increased superintendent’s authority, and it offered more space for patient’s relatives to describe the status of the insane. On the investigative side, however, it introduced several important domains of inquiry such as previous treatment, speech, course of illness, sexuality, and masturbation.

Workman’s Circular consisted in a prescribed list of 13 questions (which became 15 by 1865) including a variety of new domains of inquiry. Besides reproducing some of older Forms of Admission’s entries, it interrogated potential lameness, physical diseases, whether insanity manifested as chronic or episodic case, what treatment was pursued before, and whether speech was affected or not. These questions not only enlarged the spectrum of investigation, but they also invited ordinary people to familiarize with the world of professional alienists. Whoever was filling these papers, in fact, learned which elements were deemed important for defining the peculiarities of the insane. Whereas Forms of Admission presented a limited number of categories associated with lunacy, Workman’s Circular prescribed a variety of new normative criteria for judging patient’s condition.
Amidst the new themes associated with insanity stood out those of sexuality. At first, it emerged as a specific reference to a gendered figure, the “puerperal woman”. The term “puerperal” was part of the psychiatric vocabulary of the period and it assumed several connotations over time (Berrios, 1996). In the admission records of the Provincial Lunatic Asylum, “puerperal” was alternatively indicated either as a symptom or as a cause of insanity. For instance, Ellen H. a 36-year-old woman, married with ten children, dedicated to “domestic duties on a farm” was admitted as free patient to the Toronto asylum on February 5 1868. The Form of Admission filled by her husband, James H., stated that she was of “strictly temperate and industrious” habits of life. The cause of her insanity was supposed to be “physical prostration, want of sleep and domestic anxiety” and her propensities “to weep that her husband is insane”. Ellen’s Circular stated that her symptoms were simply “puerperal” (RG 10-268, B296096, Admission N° 3393). Another case, that of Ellen McC. is particularly instructive since it gives the idea of the “typical puerperal woman”. Ellen was admitted as a pay patient on December 31 1872. At the time of her confinement she was 34, married, with two children. Her occupation was said to be “farmer’s wife” and her religious persuasion “Roman catholic”. Her husband, William McC., who was filling the Form of Admission, stated that she was of “active, temperate, and industrious” habits of life and that it was her second attack of insanity. Her propensities included “wandering away, imagines people are conspiring to injure her”. Ellen’s supposed cause of insanity was “puerperal mania”, as her husband put it. Ellen’s condition, however, was better explained by Dr. Ford, the physician helping Mr. McC. in filling up the Circular. In listing Ellen’s symptoms, Dr. Ford stated that Ellen presented “all the peculiar symptoms of a case of ‘puerperal mania’ – is very violent at times, refuses frequently to take any nourishment, uses obscene language, wanders away into the fields and woods at every opportunity” (RG 10-268, B296098, Admission N° 4007). Besides the “puerperal woman”, Workman’s Circular opened a discursive space for defining a second figure of sexual aberration, that is the “masturbating adolescent”. This time, however, the emergence of such category was propelled by a specific entry. On July 1 1864, six months after the original version, a Question 14 was added to Workman’s Circular. The initial formulation of this question recited: “Is the patient known, or suspected, to be addicted to any secret bad habit?” (RG 10-268, B296095, Admission N° 3057). Such phrasing appears rather cryptic. In fact, what does this question refer to precisely? What is a “bad habit”? Why is it supposed to be “secret”? What kind of investigation should be pursued? And by who? Let’s try to address these questions in order.

First and foremost, it is important to understand what mid-nineteenth century Ontarians reported as a “secret bad habit”. Looking at the very phrasing of the entry, it seems that the Question 14 aimed at eliciting something that people performed with regularity, something that it was said to be negative for health or morality, something that it was kept hidden because of its potential harm. To many, this entry represented a rather nebulous area of speculation. In several cases, in fact, people filling up the Workman’s Circular appeared rather confused when addressing the Question 14. For instance, the first applicant who was ever presented with this issue was a 37-year-old Scottish “laborer” described of “steady habits of life”. His propensities were described simply as “fear” and his Form was filled probably by his wife, Mrs. Cam. The Circular talked about his difficulty in eating good food, sleeping, and speaking, whereas in regards of secret bad habits, the writer stated vaguely “no, has been addicted to anything [sic]” (RG 10-268, B296095, Admission N° 3057). To other writers, instead, the Question 14 might have alluded to problems related to drinking, smoking, and gambling. For instance, Jennet C., a 34-year-old “farmer’s wife” from Scarborough, married with seven children and described of “quiet and industrious” habits, was awarded admission on August 28 1867. Although the Form of Admission was filled by his husband, John C., the Circular was completed by a physician who was well-versed in the psychiatric literature of the time. This doctor said that Jennet received previous treatment for “puerperal mania” and the present symptoms are “religious monomania with tendency to suicide”. She was said of having “attempted suicide both by cutting her throat and hanging herself” and that “her brothers have been insane, one committed suicide”. As for secret habits, the doctor said that “not that we are aware of, unless smoking may be regarded as such” (RG 10-268, B296096, Admission N° 3326).
Many people were thus unsecure about the specific meaning of the Question 14. Despite these cases of uncertainty, however, there was a specific domain that this entry was targeting, that is masturbation. In fact, from the archival records of the Provincial Lunatic Asylum during 1863-1873, it is clear that the large majority of people answering this question reported concerns about onanism and self-abuse in young men and women. Differently to other entries, the Question 14 was very sensitive to age and gender. It can be said that it was specifically directed to young, single boys and girls residing in Ontario living with their families. The group of people that was most likely to be “guilty” of secret bad habits were single young men between 16 and 28 years of age. Take the example of Alexander W., a 20-year-old single carpenter from Ramsey. He came from a Presbyterian family and according to the Form of Admission filled by his father, William Wilson, he was described of “very regular and temperate” habits of life, he never had any previous attacks of insanity, he had “no particular” propensities or hallucinations, he was not suicidal nor violent. The circular stated that Alexander “talks incessantly and irrationally, and while on board the cars a few days ago would have jumped off while in full motion if he had not been prevented”. The cause of his lunacy appeared unanimous both in the Form and in the Circular. Masturbation was claimed to be cause of Alexander’s insanity and in answering the Question 14 it was simply stated “yes, to masturbation” (RG 10-268, B296096, Admission N° 3622). In a similar case, Michael O’Don. a 23-year-old single laborer from Wellington was admitted as a free patient on December 30 1871. He grew up in a Roman Catholic family and he had no previous attacks before that. The suppose cause of Michael’s insanity was said to be “masturbation” while his propensities were “exposing his penis in public” (RG 10-268, B296097, Admission N° 3861).
Although young men constituted the main suspects of masturbation, the Question 14 also targeted women. This happened, for instance, to Caroline C. admitted as a pay patient to the asylum on March 17 1870. Caroline was a 20-year-old single spinster from Yorkville. According to the information included in her Circular, she was of “good health” although “complaining of pains in her stomach and side”. Her symptoms were described as follows: “attempting to take her life. Wishes to run away and drown herself. Jump out of the window. Will not take food or drink of any kind. She is perfectly quiet but seems to have a settled determination to destroy herself. We have had to confine her”. As for the Question 14, the physician filling the Circular wrote: “she is very much addicted to self-abuse with her finger” (RG 10-268, B296096, Admission N° 3589). In another case, Margaret C., a 24-year-old married woman from Toronto with two children was admitted as a free patient on September 11 1870. Her husband, Robert C., stated that she was of “temperate” habits of life and her propensities “occasionally singing, reading, often abusive”. The Circular, filled in by a very shaky hand and imperfect English, stated that she was in “good health” and that she was “very talkative & contrary & violent”, “she threatens when she cant have own way [sic]”. From the answer provided to the Question 14, she was said to be “very treacherous and sly” (RG 10-268, B296096, Admission N° 3647). Workman’s Circular thus stimulated an exploration of people’s secret bad habits. In particular, it increased attention towards youngsters’ masturbation hence framing the domain of sexuality according to the parameters of the normal and the abnormal. At this point, we have to discuss how bad habits were to be inquired.

First of all, who was supposed to investigate people’s bad habits? How could one interrogate such a “secret” domain? Did it require some special carefulness? From the asylum records of this period, it seems that secret bad habits were inquired by physicians, by patient’s acquaintances, and by physicians and acquaintances together. In a first scenario, medical practitioners were involved. On May 19 1869, for instance, Thomas W. a 65-year-old man from Guelph, widow with four children, was admitted as a free patient. He was described by his brother John Watson as a man of “temperate” habits of life and the supposed cause of his insanity was said to be “general debility”. His symptoms were described as “thinks himself superior to most persons, wanders about and is very fond of going to Church”. As for body health, it was declared as “good” although he was “increasing in weight” but “no farmer disease”. Thomas’ speech was said to be “affected” and his articulations and walking were said “to be not perfect”. As for the Question 14, “no his medical adviser thinks not” (RG 10-268, B296096, Admission N° 3504). In the case of Charles T. admitted on June 3 1869, moreover, the Circular stated that his symptoms presented “at first patient was violent, and that he was sent by God to save the world. Now is quieter but still has the same idea about his mission to save all mankind. At times claim to be Maximillian of Mexico, Prince of Wales, etc.”. As for the Question 14, the local physician filling the circular stated “cannot ascertain further that he has been in the habit of frequent sexual indulgence with his wife” (RG 10-268, B296096, Admission N° 3664).
In a second scenario, secret bad habits were to be investigated by patient’s acquaintances. Family members, of course, were the ones more exposed to the task. On December 27 1870, Alexander D., a 28-year-old single farmer from Waterloo was admitted to the asylum. He applied through Workman’s Circular on December 22 and was certified by three physicians and the Reeve of Waterloo on Christmas Eve. He was Presbyterian and of “sober” habits of life. He was said to have propensities of “peculiar ideas of religion”, in particular, Alexander thought “his soul was lost”. His father, John D., wrote that the supposed cause of his insanity was “masturbation” and to the Question 14, he was simply stated “yes”, he was addicted to secret bad habits (RG 10-268, B296097, Admission N° 3718). In a similar case, Thomas A., a 24-year-old farmer from Walpole was awarded admission as a pauper patient on February 11 1864. The Circular dated February 4 was filled by John A., a supposed relative of the applicant, whereas the form of admission dated February 9 was filled by the Reverend John Briggs. On the same date, three local physicians and Robert Waldhook, Reeve of the Township of Walpole certified the lunacy of Thomas. In this case we know that the examination took place at the Reeve’s private home in Walpole, as the Form stated “Done at my house”. Thomas’ habits were declared of “a superior kind”. The supposed cause was initially said to be “unknown”, but a different pen of a different color added that the cause was “masturbation”. As for Thomas’ propensities, he was said to be “full of stranger imaginations”. The Question 14 filled by Thomas’ father, stated “religious self-accusal, unpairdonable addiction to masturbation [sic]” (RG 10-268, B296095, Admission N° 2993). At times, even friends had a role in the investigation. In the case of Cinthya V., for instance, a 28-year-old housekeeper from Wellington described of “quiet and steady” habits of life, she was said to have no secret bad habit, at least “none that her friends are aware of” (RG 10-268, B296096, Admission N° 3295).
In a third scenario, responses to the Question 14 resulted from a collaboration between doctors and relatives. One of such cases was that of John McD., a 29-year-old clerk from Toronto. John was described of “religious” habits of life with propensities of “fear, anxiety, and says he is possessed by devils”. The cause of his insanity was said to be “unknown” but his father, filling the Form of Admission stated that he “causes great anxiety to friends”. The Circular filled by a certain Dr. Kennedy with the help of John’s father reinforced the profile of a young man “talking to himself when alone” and fancying all sorts of things. As to the Question 14, Dr. Kennedy said that “we have used diligence, but we have been able to ascertain anything” (RG 10-268, B296096, Admission N° 3365). In a similar case, patient’s sexuality was interrogated by both physicians and relatives. On October 29 1867 a Circular was sent to Joseph Workman’s office asking for a 26-year-old man from Toronto to be admitted to the asylum named George Leonard L. His symptoms were reported as “loss of memory, very taciturn, and generally very sad”. In answering to the Question 14, his father Edward with the collaboration of Dr. Kennedy, affirmed “yes, to masturbation, since he was 14 years of age”. Dr. Kennedy wrote at the bottom of the Circular that “the replies to the above interrogations are filled in by the father of the patient and are believed correct”. On December 27, he was admitted to the Provincial asylum as a free patient (RG 10-268, B296096, Admission N° 3382).
Workman’s Circular thus introduced an additional normative space for describing the insane. While asking for more details about the conditions of lunacy, it propelled the idea of secret bad habits. These habits had to be investigated and carefully reported. Medical practitioners, relatives, and friends they all participated in the inquiry hence exposing patient’s sexuality to a public domain. Following this analysis, it should be noted that the Question 14 not only promoted an investigative style, but it also introduced a culture of suspect about people’s privacy. In linking insanity to secret bad habits, indeed, the Question 14 invited local practitioners and relatives to look also at this aspect when describing the insane. Even when nothing relevant was found into patients’ story so to justify their derangement, they could be nonetheless “suspected” to have incurred in self-abuse. In this way, therefore, Workman’s Circular invited ordinary citizens to suspect the occurrence of insanity as a result of sexual aberration.
It should be noted, moreover, that such question must have provoked a certain embarrassment to families, friends, and whoever was filling the Circular. In fact, for a nineteenth-century Canadian farmer or laborer, providing official declaration that a son, a daughter, a husband, or a brother abused of him/herself certainly constituted a reason for regret and shame. If having an insane relative represented a motif of social embarrassment, having a relative who was an insane masturbator was arguably even more shameful. It is not surprising, therefore, that people had mixed reactions to the Question 14. At times, humiliation reflected through these records. For example, George R. a 21-year-old single Catholic farmer described of “rather cleanly” habits of life, was admitted as a free patient on March 6 1868. His attack was said to be lasting for “about five months” and a “tonic treatment” had been pursued with no results. George’s health was “good” and his symptoms were described as “melancholy and alarme [sic]”. In answering to the Question 14, the Sheriff with the help of George’s family stated that “regret to say that he is supposed to be a subject of masturbation” (RG 10-268, B296094, Admission N° 2956). In other instances, however, some people utterly rejected any suspect of immoral conduct. For example, in the case Sarah A., a 62-year-old single “saleswoman” from Toronto, the Question 14 was perceived somewhat as an offence. According to John A., a possible relative of Sarah’s, she appeared to be of “temperate and regular habits” and the cause of her insanity was “not exactly known”. She had propensities of “screaming at intervals; strange fancies; desires to lie in bed; thinks she is lost with no hope of salvation”. In answering to Question 14, John A. explicitly denied any sign of bad habit. He replied “no! strictly moral and conscientious”. Nonetheless, Sarah was admitted as a pay patient on March 22 1872 (RG 10-268, B296097, Admission N° 3893).

From the admission records of Provincial Lunatic Asylum, it appears that during the 1860s and 1870s in Ontario, rising concerns about human sexuality begun to penetrate into standardized forms. The profiles of the “puerperal woman” and the “masturbating adolescent” constitute examples of such sensibility. It is a coincidence, perhaps, that Michel Foucault in his introductory volume of a never-completed history of sexuality made a similar argument. Besides the “Malthusian couple” and the “perverse adult”, he argued that nineteenth-century discourses around sexuality in the West gravitated around the figures of the “hysterical woman” and the “masturbating child” (Foucault, 1978, p. 103). While this paper does not propose a Foucauldian interpretation of the history of psychiatry, it does provide archival material to support Foucault’s argument. Specifically, it corroborates the idea that by the second half of the nineteenth century sexuality emerged as a domain of psychiatric concern, as a new space of normalization (Davidson, 2004; Foucault, 2003).

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Statutes of Upper Canada (1853) An Act for the better management of the Provincial Lunatic Asylum at Toronto, Chap. 187-188.

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