For what it's worth:
***** Selections from: _The Female Malady: Women, Madness, and English Culture, 1830-1980_
By Elaine Showalter
New York: Pantheon Books, 1985.
Neurasthenia
Neurasthenia, the third disorder of the 1870s, was a more prestigious and attractive form of female nervousness than hysteria, although it shared so many of hysteria's symptoms that even specialists could not always distinguish between the two. Like hysteria, neurasthenia encompassed a wide range of symptoms from blushing, vertigo, headaches, and neuralgia to insomnia, depression, and uterine irritability. Dr. George Savage's description of the neurasthenic, for example, incorporated some of the sexual stereotypes of the hysteric:
A woman, generally single, or in some way not in a condition for performing her reproductive function, having suffered from some real or imagined trouble, or having passed through a phase of hypochondriasis of sexual character, and often being a high nervous stock, becomes the interesting invalid. She is surrounded by good and generally religious and sympathetic friends. She is pampered in every way. She may have lost her voice or the power of a limb. These temporary paralyses often pass off suddenly with a new doctor or a new drug; but, as a rule, they are replaced by some new neurosis. In the end, the patient becomes bedridden, often refuses her food, or is capricious about it, taking strange things at odd times, or pretending to starve. Masturbation is not uncommon. The body wastes, and the face has a thin anxious look, not unlike that represented by Rossetti in many of his pictures of women. There is a hungry look about them which is striking.
Unlike the disagreeable and disliked hysterics, however, neurasthenics were thought to be cooperative, ladylike, and well-bred, "just the kind of woman one likes to meet with," one doctor declared, "sensible, not over sensitive or emotional, exhibiting a proper amount of illness . . . and willingness to perform their share of work quietly and to the best of their ability." Physicians often contrasted the hysteric's belle indifference and moral turpitude with the neurasthenic's "refined and unselfish nature."
Originally, neurasthenia was an American disorder, described as "American nervousness" by the neurologist George Miller Beard in the late 1860s. Beard saw a significant correlation between modern social organization and nervous illness. A deficiency in nervous energy was the price exacted by industrialized urban societies, competitive business and social environments, and the luxuries, vices, and excesses of modern life. Five characteristic features of nineteenth-century progress - the periodical press, steam power, the telegraph, the sciences, and especially the increased mental activity of women - could be held to blame for the sapping of American nervous strength.
American nervousness was alarmingly frequent "among the well-to-do and the intellectual, and especially among those in the professions and in the higher walks of business life, who are in deadly earnest in the race for place and power." The labors of domestic servants, the harshness of rural existence, the brutalities of savage tribes, were nowhere near as mentally wearing and exhausting as the refinements of civilization. Masturbation, for example, could rapidly deplete the nervous force of the refined, but "strong, phlegmatic Irish servant-girls may begin early in the habit of abusing themselves and keep it up for years, with but little apparent harm." And the Indian squaw enjoyed her "slow and easy drudgery . . . in the open air," spared the "exhausting sentiment of love," while the sensitive white woman had the more demanding anxieties of romance to handle. It was absurd to expect that a Southern black should suffer from nervous diseases, or that insanity, epilepsy, and neurasthenia should flourish on the banks of the Amazon or the Nile.
In the United States, neurasthenia was seen as an acceptable and even an impressive illness for men, ideally suited to a capitalistic society and to the identification of masculinity with money and property. Many American nerve specialists, including Beard himself, had experienced crises of nervous exhaustion in their own careers, and they were highly sympathetic to other middle-class male intellectuals and professionals tormented by vocational indecision, sexual frustration, internalized cultural pressure to succeed, and severely repressed emotional needs. When Herbert Spenser visited the united States in 1882, he was struck by the widespread ill-health of male intellectuals and businessmen: " In every circle I have met men who had themselves suffered from nervous collapses, due to stress of business, or named friends who had crippled themselves by overwork." An elaborate system of cures, including nerve tonics, galvanic belts, electric faradization, health spas, and retreats catered to the prosperous neurasthenic seeking help from his sexual problems or nervous exhaustion.
The majority of American neurasthenic patients, however, were female, often educated, urban, and middle-class. In such essays as "Neurasthenia and Its Relation to Disease of Women" (1886), Dr. Margaret Cleaves, herself a sufferer who would describe her experience in the anonymously published Autobiography of a Neurasthenia, attributed female neurasthenia not simply to overwork, but to women's ambitions for her intellectual, social, and financial success, ambitions that could not be accommodated within the structures of late nineteenth-century society. She herself was the daughter of a doctor who had encouraged her to pursue a medical career. Nonetheless, she felt, "women, more than men, are handicapped at the outset, not necessarily because they are women, but because, suddenly and without the previous preparations that men for generations have had, they attempt to fulfill certain conditions and are expected to qualify themselves for certain work and distinctions." It may be true, she concedes, "that girls and women are unfit to bear the continued labor of mind because of the disqualifications existing in their physiological life." Beard, too, had felt that women were more at risk than men in trying to follow careers, since they were accustomed to using their brains "but little and in trivial matters." At several points in her life, Cleaves suffered what she called a "sprained brain," and had to take a leave of absence from her work to recuperate.
English psychiatrists quickly picked up the neurasthenia diagnosis as an apt description of English nervousness. They maintained that neurasthenia was "neither a modern nor an American disease only" but simply a new name for what they had long called spiral irritation, neuralgic disease, or nervous weakness. Neurasthenics were viewed as borderers, denizens of Driftland and Mazeland whose mental organization was weakened by hereditary predisposition. Furthermore, in its passage from America to England, neurasthenia is mainly associated with young women. "Inasmuch as neurasthenia is mainly congenital," wrote a late Victorian expert, "and always associated with chlorosis . . . it is natural that the female sex, being more sensitive, should be more subject to it." For many late Victorian female intellectuals, especially those in the first generation to attend college, nervous illness marked the transition from domestic to professional roles. Similar to the fears and depressions described by Nightingale, Bronte, and Craik in the 1850s, these protracted and vaguely understood illnesses were now subsumed under the label of "neurasthenia." From the pioneering doctor Sophia Jex-Blake to the social worker Beatrice Webb, New Women and nervous illness seemed to go together. (pages 134-137)
Showalter, Elaine. The Female Malady: Women, Madness, and English Culture, 1830-1980. New York: Pantheon Books, 1985.
<http://www.geocities.com/Athens/Acropolis/6998/neurasthenia.html> *****
Also check out _Inventing the Psychological: Toward a Cultural History of Emotional Life in America_, eds. Joel Pfister & Nancy Schnog, New Haven: Yale UP, 1997. Here are some reviews of the book: <http://www.historycooperative.org/cgi-bin/justtop.cgi?act=justtop&url=http://www.historycoop.org/journals/ahr/104.4/br_11.html>; & <http://muse.jhu.edu/journals/american_literature/v071/71.4castiglia.html?>.
Yoshie