The Paradox of Prudence Mental Health in The Gilded Age

The Paradox of Prudence: Mental Health in the Gilded Age
Author(s): Barbara Sicherman

Reviewed work(s):
Source: The Journal of American History, Vol. 62, No. 4 (Mar., 1976), pp. 890-912
Published by: Organization of American Historians
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The Paradoxof Prudence:
MentalHealthin theGildedAge
BARBARA SICHERMAN
iHYSICIANS in the late-nineteenthcenturytook the lead in tellingthe

American public what must be done to preventmental illness and to
promotemental health. If the advocates of "mental hygiene"-asylum
superintendents and neurologistsfor the most part-wrote with urgency,
it was because theyjudged insanitydifficult if not impossibleto cure and
theircountrymen especiallyprone to mentaland nervousdisorders.They
also sharedwithmanymedicalcolleaguesthe optimisticbeliefthatmodern
sciencewould soon conquerthe scourgesof mankind,includinginsanity.'
Although mental hygienistsbelieved that their advice conformedto
scientificcanons,theirconceptionof healthrevealsmore about theirown
values,and particularly theirfears,thanaboutthenatureof health.2Indeed,
it is this subjectivity
that is of importanceto historians.Since definitions
of mentalhealthin the Gilded Age differnot only fromthosein current
use but also fromthose in use a generationlater,theyprovidean insight
to a particularculturalethos. The contextwas distinctlymedical. From
their clinical observationsof patientswho had failed to meet life's de-
Barbara Sichermanis a researchassociate in RadcliffeInstitute.Researchfor this article
was supportedin part by a grantfromthe National Instituteof Mental Health, U.S. Pub-
lic Health Service,and by the RadcliffeInstitute.The author wishes to thankYale Uni-
versityand George Beard Walker for permissionto cite the George M. Beard Papers, and
the SchlesingerLibraryof RadcliffeCollege and the heirs of Mary Putnam Jacobi for
permissionto cite the Mary PutnamJacobi Papers.
'The term"mental hygienist"is used because "psychiatrists," as theyare now defined,
did not exist in the late-nineteenthcentury.The nearestequivalentswere superintendentsof
asylumsfor the mentallyill and neurologistswho specialized not only in organicdiseases,
like multiple sclerosis,but also in what are now designatedas psychoneuroses. This essay
focuses on the physicians'definitionsof mental health. See also Barbara Sicherman,"The
Quest for Mental Health in America, 1880-1917" (doctoral dissertation,Columbia Uni-
versity,1967), 78-152.
2 For the relationshipbetweendefinitions of mentalhealthand values, see Marie Jahoda,
CurrentConceptsof Positive Mental Health (New York, 1958), 3-4; M. BrewsterSmith,
"'Mental Health' Reconsidered:A Special Case of the Problem of Values in Psychology,"
AmericanPsychologist,XVI (June 1961), 299-306.
890

Paradoxof Prudence 891
mands, physiciansdrew conclusionsabout the ills of societyas well as
the personal weaknessesof the victims.
Although at times banal and even condescending,mental hygienists
grappled with the same problems that troubled many of their con-
temporaries:ambition,when boththe rewardsof successand the penalties
of failureseemed particularly high; spiritualvalues, when religiousdoubt
flourished;and ill health,when some men, women, and especiallychil-
dren often died prematurelyand debilitatingdiseases kept othersfrom
enjoyinglife. At a time of decliningconfidencein religionand growing
reverencefor science, physiciansquite consciouslyofferedguidance on
behavioral matterswhich, as one explained, "the custom of centuries
has wrongfully confidedexclusivelyto theprofessionof theology."3
The physicians'advice to theircontemporaries was sometimesfashioned
out of their own lives. George M. Beard and Mary Putnam Jacobi
clearly illustrate the continuitybetween personal experiences of de-
pression, religion, and childhood fears, and an interestin preserving
mental health. Beard, a zealous neurologist,popularized neurasthenia
(literally,weakness of the nerves) as a medical diagnosis, worked to
improvetreatmentof the mentallyill, and tried to incorporatepsycho-
logical data into the ratherinhospitableframeworkof late nineteenth-
century somaticmedicine.Jacobi,a sophisticatedphysicianof broadmedical,
literary,and philosophicalinterests,specialized in neurologicaland chil-
dren's diseases.For neitherBeard nor Jacobihad a sense of purposecome
easily. Both had been preoccupiedwith sicknessin childhood and ado-
lescence;bothhad earlyencounters withpersonaltragedyand feltan intense
need to find some useful way of servinghumanity;and both had also
acquired an exactingmoral scrupulosityfrom zealous familymembers,
which, if theydid not entirelyshake off,theylater channeledinto pro-
fessionalpursuits.4
Not all mental hygienistsresponded to similar pressuresin precisely
3D. A. Gorton,An Essay on the Principlesof Mental Hygiene (Philadelphia, 1873), ix.
4The careerpatternsand personalitiesof George M. Beard and Mary PutnamJacobidif-
feredin several importantrespects.He was a physicianof modestscientifictraining,an in-
dividualist,and an eager controversialist
more interestedin philosophythan in meticulous
research-tendenciesviewed with alarm by some colleagues. She was an exceptionallywell
trainedphysicianwho wrote closely reasoned papers and worked activelyin New York's
medical schools and hospitals.Despite barriersagainst women,Jacobi's brillianceand no-
nonsenseapproach gained her entryinto the city'smost prestigiousscientificand medical
institutions.But in theircommitment to mentalhygieneand in the emotionalor religious
motivationsfor their choice of vocation, the similaritiesbetween them significantly
out-
weigh the differences.In the early 1880s both also participatedin an organizationthat
aimed to preventmentalillness as well as to reformmentalhospitals.He was treasurer;she
was vice-president.

892 The Journalof AmericanHistory
the same ways. But therecan be littledoubt that experiencesof this sort
shaped their hopes and fears, their conceptionsof mental health, and
in some cases theirchoice of profession.Those who had triumphedover
such difficulties
had reasonto pass on whateverwisdomtheyhad acquired.
By devotingthemselvesto healingothers,perhapseven as theywould have
liked to have been cared for as children,theymay have discoveredthe
purpose in living thathad once eluded them.5
Mental hygienistswho came to professionalmaturityin the 1860s
and early 1870s were membersof possiblythe last generationexpected
to undergothe traditionalreligiousconversionexperience.This generation
was also the firstto feel the impactof evolutionarytheory.The Origin
of Specieswas publishedwhen Beard was twentyand Jacobi seventeen.
And thisgenerationwas almostthe firstto embracethe canonsof an inter-
national scientificcommunity.Many of this generationfound it difficult
to reconciletheirchildhoodimperativesand theiradult values. By working
for mentalhygiene individualslike Beard and Jacobireintroducedtradi-
tionalvalues-always underthe cloak of science-and assertedtheirright,
as physicians,to lead othersto the desiredgoals.6
Advice on mental hygienein the Gilded Age resemblednothingso
much as the religiouspreceptsthese physicianshad assimilatedas chil-
dren. But theirswas a liberalized behavioralethic,bettersuited to the
more secular and bourgeois world of late nineteenth-century America.
They emphaticallyrejectedthe excessiverestraint-theabstemiousnessin
food, sex, drink, and, particularly,the obligatoryself-scrutiny-once
'These generalizationsderive from an analysis of the works and biographiesof fifty-
eight mental hygienists,all physicians.George M. Beard and Mary Putnam Jacobi went
furtherthan most mentalhygienistsin rejectingreligion,but the othersalso had been af-
fectedby the religious trainingof theirchildhood.Among those exposed to Calvinism,a
numbersufferedfromreligious terrors,nervousness,or both. Several chose medicineonly
afterseriouslyconsideringa career in the ministry.Even S. Weir Mitchell, who was the
son of a "liberal" Philadelphiaphysicianand who ultimatelybecamea broad churchEpisco-
palian, was exposed to the rigorsof Presbyterianism by his maternalgrandfather. See also
Margaret A. Cleaves, The Autobiographyof a Neurasthene.As. Told By One of Them
(Boston, 1910).
6 Charles E. Rosenbergand Carroll S. Rosenbergsuggestthe essentialcontinuumbetween
religion and health reformin two antebellumreformers.See Charles E. Rosenbergand
Carroll S. Rosenberg,"Pietismand the Origins of the AmericanPublic Health Movement:
A Note on JohnH. Griscomand RobertM. Hartley,"Journalof the Historyof Medicine
and Allied Sciences,XXIII (Jan. 1968), 16-35. The choice of careeris always a complex
matter,relatedas it is not only to childhoodimperatives,but also to opportunitiesand ex-
posure. The intricaterelationshipbetween individual values, evangelical religion,faith in
progress,and the choice of a scientificcareer (for instance,agriculturalchemistryin the
1850s) is sensitivelydiscussed by Charles E. Rosenberg,"Science and Social Values in
Nineteenth-Century America:A Case Studyin the Growthof ScientificInstitutions," Arnold
Thackray and EverettMendelsohn, eds., Science and Values: Patternsof Tradition and
Change (New York, 1974), 21-42.

imposedby evangelicalparentsor grandparents. Unable to freethemselves
fromtheirown pasts or even to follow theirown advice, it is likelythat
theycontinuedto live betweenhigh hopes and aspirationsand lingering
doubtsand fears.
In mattersof mentalhygienethe Gilded Age did not call forthheroic
virtues.Physiciansadvancedwhat has been called a "minimal"conception
of health-freedom fromincapacitatingsymptomsand good resistanceto
stress.Fearfulthateven the "utmostcircumspection" mightnot guarantee
health,theysettledfor what was prudentratherthan energizing. Health
was widelyperceivedas the absenceof illnessratherthanas a qualityin its
own right.As dramaticallycontrastedby Jacobi:
Healthis like the silentexistenceof thosehappynationsthathave no history.
But diseaserepresents the commotion, thestormand stress,the dramaand the
convulsionsintowhichthedisturbed historyof ourracehas usuallybeenthrown.
If healthwas a kindof idealizedcalm,it was also the "successfuladaptation
to the conditionsof existence."And in theGilded Age, followingHerbert
Spencer,adaptationmeantthe "continuousadjustmentof internalrelations
to externalrelations."The human organismmust mold itselfto a fixed
environment ratherthan shape thatenvironment to its own ends.8
Mental hygienistsconsideredcontemporary ill-suitedto
life particularly
health,repose, or securityof any sort. Beard gave voice to the common
belief when he declaredthatneurasthenia, a disease thoughtfrequently to
lead to insanity,was a productof nineteenth-century Americancivilization.
Not every physicianagreed that the disease was exclusivelyAmerican,
or acceptedBeard's list of causes-he emphasizedthe printingpress,the
railroad, the steam engine, the telegraph, and the increased mental
activityof women-but mostphysiciansconsideredthediseasedistressingly
common.9
Physiciansalso agreed that each man and woman possessed a limited
amount of nervousenergy.Given the seeminglyunlimiteddemands on
that supply,the wise individuallearnedto live withinthe marginsof his
7'H. Wardner, "Thoughts on Insanityand Its PreventableCauses," St. Louis Medical
and Surgical Journal,XL (April 1881), 388-89. On the distinctionbetween "minimal"
and "extended" conceptionsof health,see Smith,"'Mental Health' Reconsidered,"305.
8 Women's Medical Associationof New York City, ed., Mary Putnam Jacobi: A Path-
finderin Medicine (New York, 1925), xxiii; Henry Maudsley, The Pathologyof Mind
(New York, 1880), 85; Samuel Osgood, "Health and 'the Higher Culture,"AmericanPub-
lic Health Association,Public Health Papers and Reports,II (1874-1875), 202.
'George M. Beard, AmericanNervousness: Its Causes and Consequences (New York,
1881). For an analysisof George M. Beard's work,see Charles E. Rosenberg,"The Place
of George M. Beard in Nineteenth-CenturyPsychiatry,"Bulletinof the Historyof Medicine,
XXXVT (May-June 1962), 245-59.

endowment. Neurasthenia was theparadigmatic illnessformentalhygien-
of its victimsprovidedthe perfectobjectlessonof
ists; the exhaustion
whatmighthappento thosewhoattempted too much.Consequently,they
viewedtheindividual as a passivebeing-"tinderwaitingforthespark"-
at the mercyof hostileexternalforcesand of dangerousinternalones
as well. No wondertoo thatstrategies forpreserving healthwerelargely
defensive.'0
The mentally healthyperson, in theoryat least,soughtneither individual
fulfillmentnordaringexploitsthatmighttakehimfarfromconventional
socialnorms.On thegroundsthateccentricity approached insanity,physi-
cians even warnedagainstany coursethat departedfromaverageor
"normal"behaviorand recommended thatchildrenbe taughtto "avoid
eccentricityand not to defythe requirements of customwithoutsome
veryexcellentreason.""
Mentalhygienists agreedthatthehealthy personhad completecontrol
overhis emotions. He neverallowedhis temperto getthebetterof him,
or gave way to "depressionof spirits."In the well-conditioned brain
therewas "strictaccordance betweenthought and will." As one physician
put it: "Perfectinhibition is the sign of perfectmentalhealth."Some
claimedthateverysurrender to impulsethreatened a person'ssanity, was
in fact"a qualifiedsortof insanity,"and that"he onlyis a perfectly sane
man whosemindis in due subjection to theGod-givenauthority of the
will,whoselifeis governed byreason. "12
In their search for stability,mental hygienists also warnedagainst
all extremeemotions.Even greathappinessmightdamagethe nervous
system, althoughpresumably not as muchas grief.Theyexplainedthat
"everystrongemotion,or train of thought,temporarily affectsthe
nutrition of the nervecenters, and if suchexcitations are frequently re-
peated,thereresultsan organicphysical condition whichbecomesthebasis
of habitand character." To caretoo muchaboutanything also leftone
preyto.disappointment and loss, and thus to considerablenervous strain.
Thus, Jacobiadvised: "Healthyand justlyproportioned indifference is
essentialto healthyequilibrium."While directedprimarily to those
1
Henry PutnamStearns,Insanity:Its Causes and Prevention(New York, 1883), 47.
'l F. M. Turnbull, "Education as a Means for the Preventionof Insanity,"Journal of
Nervous and Mental Diseases, IX (April 1882), 296.
12 Wardner,"Thoughts on Insanityand Its PreventableCauses," 389, 390; Peter Bryce,
"The Mind, and How to PreserveIt," Transactionsof the Medical Associationof the State
of Alabama (1880), 255; CharlesK. Mills, Toner Lectures,LectureIX: Mental Over-work
and PrematureDisease among Public and ProfessionalMen (Washington, 1885), 21.

predisposed suchadmonitions
to nervousness, mightspeakto anyonewho
wishedto avoid "stormand stress.''13
If the healthyman lackedpassion,he was admirably compensated by
an equabledisposition.Approximating thegoldenmeanin everyrespect,
he strucka balancebetweenwork,celibacy,and abstemiousness on the
onehand,and frivolity, andindulgence
licentiousness, on theother.Mental
hygienists condemnedany kind of fanaticism, including,despitethe
recognized One superintendent
dangersof alcohol,teetotalism. explained:
"Abstemiousness and excessare not prudentliving;neither can be com-
mended."Even immoderate concernabouthealthcould undermine the
constitution:"Regularmodesof livingcarriedto excessare the road to
invalidism,andirregular limitsthehighway
habitsof livingwithinrational
to health."Prudenceitselfmightbe carriedtoo far.14
PhysiciansurgedAmericans to moderatetheirambition, theirlove of
money,and-a new concernfor this generation-their compulsionto
work.Althoughthe dangersof a competitive culturehad been decried
as earlyas 1830,physiciansin theGildedAge pittedthemselves, probably
againstpopularsuccesswriters
withlittleeffect, likeHoratioAlger.Mental
hygienists did not believethateveryAmericancould attainfameand
fortune;asylumshousedmanypatientsof aspiringtemperaments who
lackedthe abilityto achievetheirobjectives.More "modest"goals,they
claimed,wouldlead to morecertain achievement.15
Physicians did notbelievethatworkin itselfwas harmful-only"in-
temperance of work."With S. Weir Mitchell,the neurologist who de-
velopedthe"restcure"forneurasthenia, theydistinguishedbetweenwear
(normaluse) and tear (abuse). To a generation of physiciansintrigued
Is CharlesW. Page, "How Can We Escape Insanity ?" Reportof the StateBoard of Health
of the State of Connecticut,V (1882), 187; Mary PutnamJacobi,"Some Considerationson
the Moral, and on the Non-AsylumTreatmentof Insanity,"Journalof Social Science,XV,
Pt. II (Feb. 1882), 86; Beard, AmericanNervousness,119. The idea thatall experiences
of great intensity,even those generallyconsideredpleasurable,can cause stressis currently
being revived.See New York Times, June 10, 1973.
"John P. Gray, "Thoughts on Hygiene," New York State Lunatic Asylum,Utica, An-
nual Report,32 (1874), 59; JamesF. Hibbard, "The HygienicValue of Rational Irregu-
larities in Habits of Living," American Public Health Association,Public Health Papers
and Reports,XVI (1890), 189. Even in the 1950s, neuroseswere still attributedto such
extremesas povertyand wealth,overworkand underwork.See LawrenceS. Kubie, "Social
Forces and the Neurotic Process," Alexander H. Leighton,John A. Clausen, and Robert
N. Wilson, eds., Explorationsin Social Psychiatry(New York, 1957), 78-79.
"5 For the pre-CivilWar emphasis on environmental factorsin mental illness, see Nor-
man Dain, Concepts of Insanityin the United States, 1789-1865 (New Brunswick,N.J.,
1964), 84-113; and David J. Rothman,The Discovery of the Asylum: Social Order and
Disorder in the New Republic (Boston, 1971), 109-29. The views of mentalhygienistson
success resemblethose of the "Genteel Reformers";both groups came fromsimilar social
backgrounds.

by mechanicalanalogies, the body was a machine that might easily be
drivenbeyondits capacity.Their warningsagainstambitionand overwork
also revealeda distinctclass bias. They emphasizedthesedangersto work-
ing-class studentswho, by studyingLatin and algebra, acquired false
notions of their opportunitiesand believed themselvesabove manual
labor; to businessmenengaged in speculationor otherventuresof high
risk and dubious morality;to self-mademen catapultedinto positions
of responsibility for which theywere unprepared;and to the nouveaux
richeswho became self-indulgent, idle, and perhapsmorbidlyfanciful.In
practicethen,physiciansstressedthe dangersof worry,risk,or anything
thatmighttake an individualinto dangerousor novel territory.16
Whatever theirqualms about ambitionand success,mental hygienists
consideredidleness and luxuryeven more hazardousto the nervoussys-
tem. These inclined individuals to "imagine the most fascinatingper-
sonal romances.They selfishlydwell upon subjectivefeelings,developing
more and more completeegoism; theymodifysensationsinto symptoms,
and symptomsinto diseases,untilnervousinvalidsresultby the hundred."
Like other Victorians,physicianshad an ingrainedfear of fantasyand
introspection (with theirimplicationsof sexual indulgence),of eccentricity
and lack of control.These were also the traitstheydaily observedin their
own patients.'7
Mental hygienistsagreed that childhood was the best time for in-
stilling the "habits of self-control,self-reliance,devotion to duty, and
calmness"thatwould assurementalhealthin adult life.'8They seemed to
believe that parentspossessed almost unlimitedpower over the develop-
ment of their offspring."It is . . . largely in our power to determine the
nature of the ideas of any child who is thoroughlyguarded from his
cradle," Jacobiboldly asserted.She believed thatpersonalitywas built up
by incorporatingideas, feelings,and volitionsinto the originalphysical
substratumof the mind. Since disease was the "invasion of false ideas,"
the child's ego must be strengthenedto guard against the entranceof
" See S. Weir Mitchell, Wear and Tear, or Hints for the Overworked (Philadelphia,
1887); Page, "How Can We Escape Insanity?" 192-93; Stearns,Insanity,104-05; J. S.
Jewell, "Influenceof Our Present Civilizationin the Productionof Nervous and Mental
Diseases," Journal of Nervous and Mental Diseases, VIII (Jan. 1881), 14-17; Eugene
Grissom,Mental Hygiene for Pupil and Teacher. A Lecture (Raleigh, 1877), 34; Henry
M. Hurd, "PredisposingCauses of Insanity,"AmericanJournalof Insanity,XLVIII (Jan.
1887), 357-60.
" Page, '"How Can We Escape Insanity?" 197; RobertT. Edes, "High-PressureEduca-
tion; Its Effects,"Boston Medical and SurgicalJournal,CVI (March 9, 1882), 220-21.
18 C. F. Folsom, "The Preventionof Insanity,"AmericanPublic Health Association,Pub-
lic Health Papers and Reports,VII (1881), 88.

delusions.On thegroundsthatgrief,shock,excessiveegoism,and intro-
spectionmightcausementalillness,she recommended thatchildrenac-
quirea senseof theirowninsignificance in thevastschemeof theuniverse
and a capacityfor self-denial, so theycould bear misfortune in later
yearsandlearntopasseasilyfromonemoodtoanother. Moresophisticated
in heroutlookthanmostmentalhygienists, Jacobistillreachedthefamiliar
conclusion thata strongwill was thebasisforpreserving mentalhealth.'9
Despitethe emphasison emotionalcontrol,childrenwerenot to be
hurriedinto adulthood.Mentalhygienists condemnedprecocity, which
manyof themconsidered"but the tokenof an inwarddefect,"to be
repressed bywatchful parentsand teachers. Somephysicians, maintaining
thatall mental laborshouldbe deferred untila childreachedten,pre-
scribedphysicalexerciseand naturestudyforthepreservation of mental
and physicalhealth.20
Mentalhygienists sharedthe ambivalence of manyAmericans toward
intellectualendeavor.They fearedthatintellectmightbluntan indi-
vidual'smoral sensibilities
but deploredthe ignoranceof the masses.
What probablydisturbed themmostwas the "apparentwantof intel-
lectualdevelopment of the greatmajority"of patientsin any asylum.
Thus,whiletheycondemned intellectualexcess,theyagreedthateduca-
tionandculture were"strong defenses included.'
againstdisease,insanity '21
Althoughprimarily concerned withintellectual precocity,mentalhy-

gienistswarnedagainst"excitement or perversion" of thesexualinstinct.
For many,thismeantmasturbation. Theywereless dogmaticaboutthis
practicein adultsthanphysicians of thepreceding generation and many
contemporariesas well.They considered it oftena symptom ratherthana
causeof insanity.But theyagreedthatthepractice was especiallyharmful
tochildren.LikemanyVictorians whosentimentalized childrenas innocent,
theysoughtto protect themfromsexualknowledge.22
" Jacobi,"Some Considerations. . .," 77-96.
" W. H. DeWitt, "Education, Its Relation to Insanity,"CincinnatiLancet and Observer,
XIX (Nov. 1876), 998. See also Page, "How Can We Escape Insanity?"194; JosephF.
Kett,"Adolescenceand Youth in Nineteenth-Century America,"Journalof Interdisciplinary
History,II (Autumn 1971), 287.
2 John Favill, "Mental Hygiene," Wisconsin State Board of Health, Annual Report,I
(1876), 52-53; John P. Gray, "Insanity: Its Frequency:And Some of Its Preventable
Causes," New York State Lunatic Asylum,Utica, Annual Report,43 (1885), 57-60.
22 Turnbull, "Education as a Means for the Preventionof Insanity,"295-96; JamesMc-
Lachlan, AmericanBoarding Schools: A Historical Study (New York, 1970), 178. The
view that masturbationhad been over-emphasizedas a cause of insanityappeared in "Re-
ports of Societies: New York Neurological Society,"Boston Medical and Surgical Journal,
CXVI (Jan. 6, 1887), 12-14; Folsom, "Preventionof Insanity,"89; and Nathan Allen to
Dr. [Edward] Hitchcock,Jan. 20, 1862, College Archives (AmherstCollege).

A boyrearedwithdue attention to all thesematterswould,presumably,
acquirethenecessary imperturbability of character,"tested,it maybe, by
theextremity of bothjoyandsorrow-prosperity and adversity-but never
disconcerted by either."Physiciansassumedthat women,whom they
consideredmoreemotionalby natureand moresubjectto the vagaries
of theirreproductivesystems, sufferedevenmoreacutely fromthefamiliar
burdenof limitednervous and
resources excessive strain.Whilephysicians
sometimes notedtheharmcausedbywomen's"limitedsphereof physical
and mentaloccupation, as compared withthatof themalesex,"theywere
moreapt to stressthedangersof "undertaking, withperhapsinsufficient
equipment, a careerjusta littlebeyondherrealmentalstrength." Women
were urgedto choosethe safestcourse;thisinevitably meantmarriage
and motherhood.23
If mentalhealthwerelargelya matter of emotionalcontrol, thenpre-
sumablywomenas well as men shouldbe educatedto maximizetheir
rationality.
But Victorianphysicianswere inconsistent on this point.
Mitchell,for example,pointedly the
contrasted strengthening education
givenboys,whichtaughtthemto controltheiremotions, withthe in-
dulgencegrantedgirls,whichonlyencouraged themto givewayto their
alreadyheightened But he stillurgedwomennot to strive
sensibilities.
forintellectualattainment and to be contentas wivesand mothers. Al-
thoughhe hopedwomenwould becomeless impulsiveand moreself-
Mitchellopposed"evena verysteadyuse" of thebrainbefore
controlled,
a girl reachedseventeen.If she ignoredthis advice,he believed,a
girlwouldendanger herhealthand "everyprobability of future womanly
herdestiny
usefulness"; wouldbe "theshawlandthesofa."24
Jacobiwas almostalonein challenging theconventional wisdomabout
women'shealth.She attributed manyof theirills to alcoholicfathers,
venereallydiseasedhusbands,and enforcedcelibacyimposedby "bad
23 Daniel Hack Tuke, Insanityin Ancientand Modern
Life, with Chapterson Its Preven-
tion (London, 1878), 176; Stearns,Insanity,195; R. T. Edes, "The New England Invalid,"
Boston Medical and SurgicalJournal,CXXXIII (Aug. 1, 1895), 102. The relationshipbe-
tween ill health and the declining birthratewas a favoritemedical subject in the late-
nineteenthcentury.See Carroll Smith-Rosenberg and Charles Rosenberg,"The Female
Animal: Medical and Biological Views of Woman and Her Role in Nineteenth-Century
America,"Journalof AmericanHistory,LX (Sept. 1973), 332-56.
24Mitchell, Wear and Tear, 35-36, 32. For divergentinterpretationsof Mitchell's treat-
ment of women, see Ann Douglas Wood, "'The Fashionable Diseases': Women's Com-
plaints and Their Treatmentin Nineteenth-Century America," Journalof Interdisciplinary
History,IV (Summer 1973), 25-52; Regina Markell Morantz,"The Lady and Her Physi-
cian," Mary S. Hartmanand Lois W. Banner,eds., Clio's ConsciousnessRaised: New Per-
spectiveson the Historyof lWomen (New York, 1974), 38-53. See also Carroll Smith-
Rosenberg,"The HystericalWoman: Sex Roles and Role Conflictin 19th-Century America,"
Social Research,39 (Winter 1972), 652-78.

social arrangements." If womensometimes strainedthemselves to the
breakingpointin pursuitof success,it was not becauseof any native
deficiency,butbecausetheyhad beeninadequately preparedforresponsi-
bility.She criticized
hermalecolleaguesforencouraging women,already
too removedfromthe stoicismof theirancestors, to dwellon theirills.
Insistingthatweaknesscouldbe eliminated onlyby cultivating strength,
shehopedto trainbothsexesto bearresponsibility.25
The thrustof adviceon mentalhealthin theGildedAge was clearly
towardself-restriction-of emotionalattachmentandexpression, aspiration,
imagination, creativity,
evenindividuality.Fearsof goingtoo far,having
toomuchortoolittle,andlosingcontrol werenotuniquetothisgeneration.
But theyhave rarelybeen elevatedintoa rationalefordesigninga way
of life.
How did physicians arriveat a conception of healththatspecialists
todayregardas limited?The husbandingof resourceswas a central
metaphor in nineteenth-century
America, onethatdominated thecautionary
literatureon sexualbehavioras well as mentalhealth.Sincephysicians
urgedothersto leadconventional, safe,productivelives,itmaybe tempting
to interprettheirworkas an exercisein socialcontrol, intendedto keep
workers and womenin prescribed rolesandto transform middle-classboys
intoproductive clericalor professional
workers.26Buton closeranalysis,it
is apparentthattherestrictivemodelof mentalhealthwas a metaphor that
helpedphysicians makesenseof theirown professional and personalex-
periences.
Like physiciansin anyera,mentalhygienistsin theGildedAge began
withtheexampleof thosewhohadalreadybrokendown.Sincetheyhoped
to provideguidelinesbywhichothersmightavoida similarfate,it is not
surprisingthatdefinitions of mentalhealthread like an inventory of
personalitytraitsoppositethoseobservedin theirpatients.
If thementally
ill lackedcontrolovertheiremotions, wereself-absorbed, and suffered
fromdelusionsor hallucinations,thenit followedthattheindividual who
was emotionally temperate and not undulyintrospective or egotistical
' Mary PutnamJacobi,"Modern Female Invalidism,"Boston Medical and SurgicalJour-
nal, CXXXIII (Aug. 15, 1895), 174-75; Jacobi,"Some Considerations...," 77-96. See
Mary PutnamJacobi,The Question of Rest for Women During Menstruation(New York,
1877).
A thoughtfulinterpretation of the medical literatureon sexualitysuggeststhe diverse
social and personalityneeds this advice may have served.See Charles.E. Rosenberg,"Sex-
uality,Class and Role in 19th-Century America,"AmericanQuarterly,XXV (May 1973),
131-53; Rothman,Discovery of the Asylum, 109-54, 206-36; Peter T. Cominos, "Late-
Victorian Sexual Respectabilityand the Social System,"InternationalReview of Social
History,
VIII (1963), 18-48,216-50.

900 The Journal
of American
History
mustbe healthy. Physiciansbelievedthatthesedesirable
traits
providedpro-
tectionagainststress.27
Physicians of thisgeneration addressedthemselvesto humanfearsrather
thanhopes,perhapsbecausedeprivation andlosswerecommon experiences
to all classes.The deathratewas extremely highduringthesecondand
thirdquartersof the century, whenmostof the mentalhygienists had
beenchildren. As late as 1880,a male at birthcouldexpectto live only
to theage of forty two,a femaleslightly longer.Althoughsomeillnesses
were comingundercontrolby 1870, mortality fromtuberculosis and
typhoid remained high,andinfant mortalitywasvariously estimated
at one
in fouror fivelive births.The childhooddiseases-diphtheria, croup,
enteritis, and scarletfever-yielded
diarrhea, to medicalcontrolonlyafter
1900.28
Manymentalhygienists had undoubtedly lostparentsor siblingsat an
early age. Their medical trainingnotwithstanding, they were often
powerlessto save theirown children.Not everyoneexperienced such
losses,but premature deathwas commonenoughto remindeven the
fortunate thatlovedones mightdie suddenly.Perhapsthislimitedtheir
abilityto trusttheirenvironmentor counton a happyfutureand made
themlong forthe emotionaldetachment thatexpertstodayconsideran
unfortunate butprobableconsequenceof earlyseparation
fromparents.29
Certainly in theGildedAge wereoftenpreoccupied
mentalhygienists
2T For a critiqueof the practiceof
defininghealth or normalityon the basis of evidence
drawn from patients,see Daniel Offer and Melvin Sabshin, Normality:Theoreticaland
Clinical Conceptsof Mental Health (New York, 1966). The subjectsof a 1958 studyof
"normal" youngmen virtuallyembodiedthe Gilded Age definitionof mentalhealth.They
were little inclined to introspectionor fantasy,had fairlystrong impulse control,mild
emotionalresponses,and had acquired a realisticself-imagewithoutan identitycrisis. See
Roy R. Grinker,Sr., Roy R. Grinker,Jr., and John Timberlake, "'Mentally Healthy'
Young Males (Homoclites): A Study,"Archives of General Psychiatry, 6 (June 1962),
405-53.
28 For suggestive data on mortality,see Frederick L. Hoffman, "American Mortality
Progressduringthe Last Half Century,"Mazyck P. Ravenel,ed., A Half Centuryof Public
Health (New York, 1921), 94-117; and Edgar Sydenstricker, "The Vitalityof the Ameri-
can People," RecentSocial Trends of the United States: Reportof the President'sResearch
Committeeon Social Trends,I (New York, 1933), 602-60. Obviously a high death rate
was not unique to this generation,but its impactmay have been increasedby its conjunc-
tion with diminishingbirthratesand the erosion of religious reassurancesabout death.
' For the effectsof loss, see John Bowlby, "SeparationAnxiety,"InternationalJournal
of Psycho-Analysis, XLI (1960), 89-113. For Charles Darwin's effortsto "cut down on
his emotional intake" (a need related to his turningaway from religion), see Donald
Fleming, "Charles Darwin, The AnaestheticMan," VictorianStudies, IV (March 1961),
219-36. The life of Mary PutnamJacobi's husband providesa particularlytellingexample
of the high incidenceof infantand maternaldeath. It is ironic thatAbrahamJacobi,con-
sidered by manythe founderof Americanpediatrics,outlived two wives, and of the eight
childrenhe fathered,only one lived to adulthood.

with the themes of deprivation,death, and danger. In a speech on
childbirthJacobi made much of the external dangers threateningthe
individual:
Lookingbackoverour own careers, we seemto tracea narrowpathwinding
betweenso manydisasters,hereskirting a precipice,therebarelyescapingan
impending avalanche,-again,emerging froma blackquagmirethatthreatened
to engulph,-somanydangersbarelyescaped,so manyothersunescapable;-one
maywell ask whetherit be worthwhile to launchanothersentientbeingupon
sucha difficult
and dangerouscourse....
But the dangers also came from within,from the disturbingthoughts
that suggestedto physiciansof thisgenerationthatno absoluteline sepa-
ratedthe normalfromthe insane.As one of Mitchell'sfictionalphysicians
declared:
Thereare timeswhenI seemto hangawed overthe abyssof myown mind,
withwondernearakinto terror. Thatoutof thisworldof thought,feelings, and
memories shouldcome,to themosthealthynature,at timesinexplicable desires,
moments of unreason, whichdefyanalytic
impulses evenbriefinsanities,
research,
is notstrangeto me. I wonder,indeed,at thepermanenceof mentalhealth....30
The emphasis on self-restriction may have been primarilya defense
against the anxieties aroused by such threats.Mental hygienistsin the
Gilded Age offereda formulaforreducinganxiety.By limitingaspirations
they suggested,one could avoid failure,loss, and disappointment.By
stiflingimagination,theyargued,one could keep out unwantedand terrify-
ing thoughts.31Perhaps only those who wanted a great deal out of life
needed to constructsuch defenses. Whether or not mental hygienists
actuallydesiredsuch safe lives forthemselves,theywere addressingprob-
lems that had caused some of themacute discomfort-ambition,trouble-
some imaginations,morbid self-examination, fiercetempers,a sense of
theirown willfulness.Those who triumphedover such tendencies,often
by tremendouseffort,must have believed that otherscould do the same.
Those who had not entirelysucceededmay have felt compelled to warn
othersof the dangers.
Beard struggledwith many of the conflictsexperiencedby Victorians
who were rearedas Calvinists.Among mentalhygienists he probablywent
30Mary PutnamJacobi,Address [Twelfth-St.School Reunion) 1902, Folder No. 35, p. 6,
Mary PutnamJacobi Papers (SchlesingerLibrary); S. Weir Mitchell,Dr. North and His
Friends (New York, 1901), 389.
"Erik H. Erikson has suggested that neuroticanxietycan sometimesbe avoided by
laws." Erik H. Erikson,Childhood and
"concentrationon limitedgoals with circumscribed
Society (New York, 1963), 308-09.

902 The Journal
of American
History
furthestin rejectingthe constraints of thattradition.32Bornin 1839 in
Montville,Connecticut, he was theyoungest of fourchildren.His mother
diedwhenhe wasthree,andtheevidencesuggests thatatleastsomeofthe
Beard childrenlived withrelatives, perhapseven aftertheirfatherre-
marriedin 1843. It was a highlychargedreligioushousehold.Beard's
father,a Congregational minister of slendermeans,was evermindfulof
of
thetemptations earthly life.Bothof Beard'sbrothers becameministers,
and hisstepmother hopedthathe wouldalso receivethecall.33
Between1856, whenhe completedhis preparatory courseat Phillips
AndoverAcademy, and 1862,whenhegraduated fromYale,Beardsuffered
manyof the symptoms he laterincorporated underthe rubricof neur-
asthenia-ringing in theears,painsin theside,acutedyspepsia, nervous-
feeling"blue." He questioned
ness,lackof vitality, thepurposeof living
and triedto reassurehimselfthatwhenhis healthimprovedhe would
findenoughto enjoy in this world.Beard encountered manyfellow
notonlyamongstrangers
sufferers, butalso,mostimportant, in his own
family.His sisterand bothbrothers suffered fromill health,nervousness,
and "lack of vitality";thecollegecareersof his fatherand one brother
had beeninterrupted forreasonsof health.34
Determinedto recover,Beard experimented witheveryremedythat
cameto his attention.He dieted-on bread,milk,and crackers-since he
consideredovereating his besettingvice.He also soughtrelief,despitehis
family's withelectricity,
ridicule, a newand notyetmedically respectable
therapythatBeardlaterpopularized. In his efforts
to systematizea proper
regimen "orderis heaven'sfirstlaw"-Beard at twenty was verymuch
thephysicianin themaking.35
DuringtheseyearsBeardalso struggled to regain"thehumble,trustful
faithof myyounger days,thezeal, theconfiding earnestness."He could
"not bearthishangingback,"and triedto revivehis flagging pietyby
"The Place of George M. Beard in Nineteenth-Century
32 Rosenberg, Psychiatry";Charles
L. Dana, "Di. George M. Beard: A Sketchof His Life and Character,"Archivesof Neurol-
ogy and Psychiatry, X (Oct. 1923), 427-35; "George Miller Beard, A.M., M.D.," Ency-
clopaedia of Contemporary Biographyof New York (6 vols.. New York, 1883), III; A. D.
Rockwell,RamhlingRecollections.An Autohiography(New York, 1920).
" [Mary Ann Fellows
Beard] to George M. Beard, July 15, 1862, George M. Beard
Papers (Yale UniversityLibrary). See also W. H. Beard to George M. Beard, Feb. 16,
1863, ihid. For evidence of the family'sseparation, see "Rev. Edwin Spencer Beard,"
(Windham County] Transcript,n.d. (Archives of the Andover Newton Theological
School).
'George M. Beard, PrivateJournal,73-76, 82-83, 90, 103-04, 143, 172, 180, 181, 193,
200, 201, Beard Papers. See also SpencerField Beard to George M. Beard, March 14, 1866,
ihid.
" George M. Beard, PrivateJournal,75, 95, 90, 107, 112-13, 164-65, 182, ihid.

attendingprayermeetings,conductinga sabbath school, and deploring
the worldlinessof those who profanedthe sabbathby fishing,sailing,or
engagingin other "'sinful pleasures' (ice creampartiesand otherjoyful
occasions) ."36
Beard was especiallytroubledby the conflictbetweenworldlysuccess
and spiritual salvation, an understandableconcern for one who at
seventeenreceivedthe following advice from his father:
Happyto hearof yourhealth& prosperity. You will I hopebe on yourguard
againstthe dangerswhichare foundin all cases the attendants of success&
prosperity.In no condition whilein thisstateof probation are we exemptfrom
whatmaybe inimicalto our bestinterests, if not avoided.In the day of ad-
versitythereis the dangerof becomeingthereby unbelieving,unsubmissive &
despondent . . . on theotherhandin thedayof prosperity thereis thedangerof
immoderate elationof too greatself dependenceor of an overestimateof our
powers,attainments and goodness.. . . To theinjurious& hatefulinfluence of
prosperity herereferedto we are all exposedespeciallyso in earlylife before
experience has had timeto makeus see thefollyof theselfconceit& pridewhich
everis theforerunner of a fall.I havereferedto thissubjectnotbecauseI have
seen anythingspecialin yourcase,butonlyto putyouon yourwatchagainsta
dangerto whichall are exposedin thatpartof oceanof lifewhereyourbark
is now sailing.
In this situationwheneverBeard achieved any personaltriumph-even
an improvement in health-he feltconstrainedto ask if he weresufficiently
grateful.Advice of this sortmusthave contributedto Beard's depression,
especially because he consideredhimself "inordinatelyambitious,"and
wanted not only to finda useful purpose in life but also to outdistance
his fellows.37
Beard's decisionto becomea physicianfinallygave him the long sought
senseof purpose: "I wishto makemypen theservantof myprofession-to
make all my writingability of practical service in the reformation&
progressof medical & Hygienic knowledge. This is my earthlyideal."
He embracedmedicinewith the passion of a true vocation: "I love my
studies. I love them for their own sake-I can but love them. I was
born to be a physician.I should do wrong to study any other pro-
fession. . . . I have a genius-a decided taste for the Theory& Practice
of Medicine." Beard still wished he "had equal zeal in Religion," and
even as he looked forwardto life and successcould nothelp asking: "How
long will it be beforeI shall be humbled& crushed?"38
6Ibid.,154, 88, 125, 139-40, 84. For the quotation on sinful pleasures,see Rockwell,
Rambling Recollections,185.
S
Spencer Field Beard to George M. Beard, Dec. 1, 1856, Beard Papers; Beard, Private
Journal,87, 88, 96, 98, 109-10, 185-86, 201-02, ibid.
" George M. Beard, PrivateJournal,183, 204, 203, ibid.

904 The Journal History
of American
By this timeBeard had also begunto enjoythe worldlypleasures
he had once condemned.He attendedchampagnepartiesand smoked
Turkishtobacco.He also enjoyedskatingand the companyof young
ladies,and in January 1863 becameengaged.Althoughhe finally joined
a church,he did not long remaina member.By the timeBeardstarted
practicein New York City,aftera stintas assistant surgeonin thenavy,
he was, accordingto his partner,"quite positivelybut unobtrusively
agnostic."39
Beard founda profession thatpermitted him to advancehumanity's
cause as well as his own. He was eagerto do both.If Beard did not
entirelyavoid the pitfallsof ambitionagainstwhichhis fatherhad
warned-hispropensity forclaimingworld-shaking discoveriesperturbed
morecautiouscolleagues-hisaimswereundeniably He could
altruistic.
even draw on his own earlytroublesto bringcomfort to others.As a
physicianinterested in the functionalnervousdisorders, he servedindi-
vidualswho,likehimself, had temporarilylosttheirdirectionin life.He
was, in the wordsof a colleague, "intenselytherapeutical,"and even
triedremedies like"mentaltherapeutics" thathad notyetattained medical
Whateverthe specifictherapy(he insistedthatno two
respectability.
patientsshouldbe treatedalike), Beardreassured themthattheywould
recover.Since he had once declaredthat"each day is lost in whichI
havenotconferred happinesson someone," thegratitude of his patients
musthave been extremely important to him.Certainly his empathy was
apparent.40
Beard was less enamoredof the prudentvirtuesthan mostof his
He was a rebelwhowelcomed
contemporaries. and,byhisownadmission,
ttcourted" Perhapsthisqualitymade himparticularly
opposition. critical
of the "repelling. . . distressing,wearisomeand saddening" educational
methodsthathad beenforcedon "childrenof thepastgeneration"-his
own presumably-who learned"thatto be happyis to be doingwrong."
" Rockwell to C. L. Dana, Nov. 3, 1905, Beard Papers; letterinsertedin A. D. Rockwell,
The Late Dr. George M. Beard. A Sketch (New York, 1883). George M. Beard's journal
ends in 1863, shortlyafterhe joined the church.Unfortunately, thereis no survivingevi-
dence that indicates his reasons for leaving it again. Probably his medical studies and
conversionto evolutionarytheoryplayeda part.Even beforecompletinghis medicalstudies,
he had begun to directhis energiesinto popular lecturesand articleson hygiene.Beard,
Private Journal,80, 101, 145, 189, 194-95, Beard Papers.
40C. L. Dana, "Dr. George M. Beard," 429-30; George M. Beard, PrivateJournal,76,
Beard Papers. For his views on treatment, see George M. Beard, A PracticalTreatise on
Nervous Exhaustion (Neurasthenia), Its Symptoms,Nature, Sequences, Treatment(New
York, 1880). For his need for recognition,see George M. Beard, Herbert Spencer on
American Nervousness. A ScientificCoincidence (New York, 1883); "George Miller
Beard," Encyclopaediaof ContemporaryBiography.

Beard had struggledtoo hard againsthis own "hangingback" to recom-
mend it to others.Thus he preferredspeculativeGerman science to the
"dull and safe" Americanuniversity system,whichhe blamed on Puritan
ancestors,and absolutelydenied that mental activityin any way com-
promisedhealth."A well-trainedintellect,"he insisted,"is itselfmedicine
and hygiene,enablingits possessorto guardsuccessfully againsttheappeals
of passion and the stormsof emotion."This was as trueforwomenas for
men, for Beard maintainedthatintellectualwomen were rarelynervous.4'
When Beard recommendedmoderationin food and drink,he was at-
tacking the vegetarianismthat had flourishedin his youth, not only
among "popular charlatans"but also among physicians,and the teetotalist
position still advanced by clergymen.He also reassured his patients
about theirsexual problems,at a time when quacks and physiciansalike
still urged the direstremediesfor masturbationor spontaneousemissions.
Beard proposed a "gospel of rest" to promotecalmness,serenity,and
repose. But he was no great partisan of the rest cure; he had early
discoveredthat he felt best when hard at work. Before his death of
pneumoniaat forty-three, he publishedtenbooksand almosteightyarticles.
Clearly,work,intellectualengagement,and, as a hostilereviewersuggested,
his typewriter,contributedto Beard's emotionalwell-being.As a dedicated
healer, he would not denythis to others.42
Beard's experienceswith religion, doubt, and nervousnesswere not
unusual in the Victorianera. His less restrainedattitudeabout mental
health probably resulted from the intellectualand emotional liberation
that often accompaniedthe castingoffof evangelicalfaith.The greater
cautionof manyof his contemporaries may have reflectedtheirlingering
anxietiesas well as personalor familialpressures.43
Jacobibestillustratesthe paradox betweenthe lives of mentalhygienists
4" George M. Beard, PrivateJournal,157, Beard Papers. Beard, AmericanNervousness,
313-14, 336-38; George M. Beard, "Medical Education and the Medical Professionin
Europe and America," 35, 23, Beard Papers.
'George M. Beard, Sexual Neurasthenia (Nervous Exhaustion). Its Hygiene, Causes,
Symptoms,and Treatment,ed. by A. D. Rockwell (New York, 1884), 102-03, 117-28;
Beard,AmericanNervousness,313-14; Rockwell,RamblingRecollections,186; E. C. Spitzka,
"Review," of A Practical Treatise on Nervous Exhaustion (Neurasthenia); its Symptoms,
Nature, Sequences, Treatment,by George M. Beard, St. Louis Clinical Record,VII (June
1880), 93. For George M. Beard's views on food and drink,see George M. Beard, Eating
and Drinking,A Popular Manual of Food and Diet in Health and Disease (New York,
1871), 84-96; George M. Beard, Stimulantsand Narcotics; Medically,Philosophically,and
Morally\Considered (New York, 1871); ScientificReforma letterto Rev. Theodore L.
Cuyler,D.D. on the attitudeof Physiciansand ScientistsToward the TemperanceCause
(New York, 1872).
" Walter E. Houghton,The VictorianFrame of Mind, 1830-1870 (New Haven, 1957),
61-77.

906 The Journal History
of American
and theadvicetheysometimes Bornin 1842,shewas theeldest
offered.44
oftheelevenchildren ofGeorgePalmerPutnam, founder ofthepublishing
house.Despitehercosmopolitan background, she preferred ruralStaten
Islandand Yonkersto Manhattan, whereshe suffered from"ennui."She
had considerable freedom-evenhereducationwas "helter-skelter" -but
her memories of earlychildhoodwerefilledwithtalesof sickness, epi-
demics,punishment for misdeeds,and a season of nightmares and insomnia.
Perhapshernear-death by drowning at eightgaveriseto a constant pre-
occupation withillnessand death.She claimedto have been unableto
understand herparents'gratitude to theworkman who rescuedher.This
anaesthetizingof experience, in realityor in memory parallelsherlater
adviceto cultivateindifference.45
Her paternalgrandmother, an austereBaptist,tookchargeof thegirl's
well-being,
spiritual thematter
principally of rigorous self-examination for
signsof wrongdoing. At nine,she kepta diaryrecording herdailyvices
and virtues.At twelve,she informed hergrandmother of her "alarming
sins,such as passion,inordinateselfishness,envy and jealousy," of which
her "awfulpassion"was the worst.She attributed her initialsuccessin
overcoming thesevicesto a strongeffort of will, "assistedby the Holy
Ghost."Butthe"tranquillity of mind"and "a fancieddangerous security"
onlyprecededher relapseinto "careless,sinfulhabits."In thisworld,
evengood feelingscould not be trusted. She becamea Baptistduringa
religiousrevival,whena charismatic youngminister converted theentire
family.Six yearslater,at theage of twenty-one and following fouryears
of doubt,sherejectedCalvinistdoctrine and severedherrelationship with
the church.She attributed her actionto intellectual oppositionto the
principlesof probation and authority,theTrinity, atonement, and eternal
punishment. To provethat she was not motivated by worldly desire,she
promisedto abstainfromtheaterand opera for ten years,a resolution
maintained
steadfastly despitethetemptations of student lifein Paris.46
'For materialon Mary PutnamJacobi,see Ruth Putnam,ed., Life and Lettersof Mary
PutnamJacobi (New York, 1925); Roy Lubove, "Mary Corinna Putnam Jacobi," Edward
T. James,JanetWilson James,and Paul S. Boyer,eds., Notable AmericanWomen 1607-
1950: A BiographicalDictionary(3 vols., Cambridge,1971), II, 263-65; Eugene P. Link,
"Abrahamand Mary P. Jacobi,HumanitarianPhysicians,"Journalof the Historyof Medi-
cine and Allied Sciences, IV (Autumn 1949), 382-92; Victor Robinson, "Mary Putnam
Jacobi,"Medical Life, 35 (July 1928), 334-54; Rhoda Truax, The Doctors Jacobi (Boston,
1952).
"Putnam, Life and Letters of Mary Putnam Jacobi, 23-28, 32-33; Jacobi, Address
[Twelfth-St.School Reunion] 1902, Folder 35, Mary PutnamJacobiPapers.
'Putnam, Life and Lettersof Mary PutnamJacobi,28-30, 35-42, 53-59. See also "Con-
versationswith Dr. Anderson,June,1862," Folder 12, "M. C. Putnam to George H. Put-
nam, 1857," Folder 9, Mary Putnam Jacobi Papers; George Haven Putnam,Memories of
My Youth: 1844-1865 (New York, 1914), 77-78.

Precociousin ambitionas well as self-analysis,at the age of ten she
wrote: "Vague longingsbeset me. . . . I would be great." She was even
then interestedin healing,which she associatedwith the ministerialrole.
The minister-hero of a storywrittenwhen she was nine declares his
superiority
to the less noble poet and merchant:
I will notburymyself withinmyself, or uponmountains. Neitherwill I spend
mylifein theacquisition of dull gold; butwill devoteit to thesickbed, to the
cell wheredarkcrimeand poverty lurk.I will smooththepillowof thedying,
and call sinnersto God. I will snatchinfantsoutof thewilesof sin,and preach
the Gospel to all. Thus will I pass mylife,and I hope to sinkto the grave
lamented.47
To those who knew her as an adult, Jacobimust have seemed an in-
trepid and dedicatedprofessional.She was graced as well with a "keen
sense of humor . . . a suggestivewit." The firstwoman admittedto the
Ecole de Medecine in Paris, she became one of the most respectedphysi-
cians of her generation.She impressedher vitalityand determination on
familyand colleagues, which is perhaps the reason her fatherdid not
seriouslyinterferewith her ambition,despitehis convictionthatmedicine
was not an "agreeable pursuit."She was, by her own account,clear and
definitein her views and rarelyinclinedto ask advice of others.Unlike
most professionalwomen of her generation,she combinedmarriageand
motherhoodwith a career.She producedmedical papers of high quality,
taughtmedical school, did dispensarywork,wrote about philosophyand
education,and workedto improvemedical opportunitiesfor women and
factoryconditionsfor workers.She also became a fiercechampion of
Positivism,an optimisticcreed that she believed would help humanity
triumphover evil, of whichdeathwas the most terrible.48
Yet thereare puzzling contradictions about Jacobithatsuggestthe con-
tinued impactof her early experiences.Her professionalaspirationsand
her interestin feministcauses did not keep her fromvoicingthe wish-
should she marryat all-to find a man more eminentthan herselfand
more interestedin his work than in her. And when she marriedin 1873,
her husbandhad alreadymade his markas a founderof Americanpedi-
atrics.Althoughshe once thankedher parentsfor allowing her so much
freedomas a child,she supervisedher daughter'slife to such a degreethat
Putnam,Life and Lettersof Mary PutnamJacobi,31, 29.
4 Women's Medical Associationof New York City,In Memoryof Mary PutnamJacobi,
Tanuary4, 1907 (New York, 1907), 5; Putnam,Life and Lettersof Mary PutnamJacobi,
16, 106. For Mary Putnam Jacobi's defense of Positivism,see Mary Putnam Jacobi, The
Value of Life: A Replyto Dr. Mallock's Essay 'is Life WorthLiving?' (New York, 1879).

908 The Journal
of American
History
thechildexclaimed:"You makeeverything a lesson,Mama." Whenup-
braidedforthisbyherownmother, Jacobireplied:"Whenshe can pick
the flowerit seemsa pitynotto havehernoticewhatshe latelylearned
aboutit." Perhapsshewas moreambivalent aboutherown independence
thanshe caredto admitand had cravedmoreattention thanshe received
fromherownyoungmother, whohad beenbusywitha largebrood.49
whatsheprobably
Jacobirejected considered themostdestructiveaspects
of herown upbringing, includingthe"constant gloom"of a "ferocious"
religion.She warnedagainstdoctrinal trainingon the groundsthatany
"uprooting of fundamentalreligiousideas"was invariably On
disturbing.
learningof her grandmother's death,she tartlyobservedthatthe old
womanhad been "mostrarein her entireignoranceof herself.I think
thatwas reallyastonishingespeciallyin a personwho devotedso much
timeto self-analysis
and introspection."Jacobifoundit "highlyfavorable
forpeaceof mindand effective action,to dwelluponwhatI am sureof
and notto be distressed
bywhatremainsuncertain." Yet, heradviceon
childrearingresemblesadmonitions she mustoftenhaveheardfromher
grandmother. The sinsshe ownedup to at twelve-"passion,inordinate
envyand jealousy"-resemble
selfishness, the traitsshe thoughtparents
mustguard againstin theirchildren,egotism,willfulness, passionate
attachments.50
Jacobi'sadmonitionto cultivate"justlyproportioned indifference"
had
less to do withanylackof feelingon herpartthanwithan intenseneed
to avoidpainor lossandto cometo terms withherfears.As a youngadult
she keenlysensedtheprecariousness of healthand happiness:"I do not
knowanytimeof mylifethatI havenotbeenmoreafraidof losingthe
presentthanreallysanguineaboutthefuture."On hertwenty-fifth birth-
dayshewondered whysheshould"nearlyalwayshavewhatI want,when
hardlyanybody elsehas." If shesuddenly becamean invalidorcripple,she
claimedit wouldbe "onlyfairbalanceforthe uninterrupted happiness
thathas been grantedme." She also fearedtidingsof deathwhenever
mailarrived. Whilesheattributed thisto "livingso constantly
in thepres-
ence of death,"her decisionto entermedicinemayhave represented a
needto facetheenemysquarely.51
"9Putnam,Life and Letters of Mary Putnam Jacobi, 80-82, 322-23, 110-11. Victorine
Haven Putnamwas eighteenwhen Mary Putnamwas born; the next child arrivedeighteen
monthslater.Ibid., 15. JoyceCushmore,"AbrahamJacobi: Fatherof AmericanPediatrics,"
American-German Review, XXV (Aug.-Sept. 1959), 29-31, 37.
'Jacobi, "Modern Female Invalidism," 174; Jacobi, "Some Considerations. . .," 89;
Putnam,Life and Lettersof Mary PutnamJacobi, 203, 105-06.
51Putnam,Life and Lettersof Mary PutnamJacobi, 117, 141-42, 123, 203.

Jacobiseemsto have cultivatedqualitiesshe suspectedwere not natively
hers. Noting that "a more miserablecreaturethan a human being in a
stateof fear,-of terror-can scarcelybe imagined,"she deplored effemi-
nacy and women's penchantfor cultivatingweakness. In comparisonto
heroeswho riskedtheirlives a fearfulpersoncould only "feel the bitter-
est self contempt"for such qualities.Perhapswhen she traveledalone to
New Orleans to nurseher brother,a soldier in the Union army,through
a bout of malaria,she made clear her intentionneverto be one of those
who "fall asleep at his post."52
It is particularlyironic that Jacobi's descriptionof the change in per-
sonalityaccompanyinga meningealtumorthateventuallycaused her death
bore a strikingresemblanceto her earlierdefinition of health:
I beganto lose theinitiative,whichhad formerly beenso activewithme. I
was not at all depressedor melancholy, but relatively It seemedas
indifferent.
if a finegauzeveil werethrown overall theobjectsin whichI had formerlybeen
so intensely It was like thelifeafterdeathas theGreeksunderstood
interested.
it whentheydescribedHades.
That Jacobicontrastedthis stateof indifference with her earlier"vivacity
and strength"suggeststhatshe had not attainedthe "justlyproportioned
indifference"she recommendedto others. Indeed, given her statement
elsewherethat"the objectof living . . . consistsin the developmentof all
facultiesto theirgreatestextentto which the individualorganizationad-
mits of, and in the satisfactionof all desiresto theirutmostpossible ca-
pacity,"it is unlikelythat she ever reallywished to achieve such a state.
For to the question "What do you want from Life?" she had once
answered: "Everything."To one who alternately emphasizedthe feasibility
of triumphingover evil and the precariousnessof life, the admonitionto
cultivateindifferencemusthave been a self-protective device.53
On balance, mental hygienists'views on health representedat once a
partialemancipationfromtraditionalreligiouspreceptsand a reaffirmation
of theiressentialpremises.Jacobiwas probablynot aware of the similarity
betweenher ideas on child rearingand the religiousperceptsthatshe had
learned as a child and laterconsciouslyrejected.But some who remained
formallyreligious,among them the superintendent of the HartfordRe-
treat,who was also directorof the ConnecticutBible Society,made the
connectionexplicit:
Mary Putnam Jacobi, "Effeminacy,"Folder 3, "Fugitive Papers Before 1873," Mary
PutnamJacobi Papers. A referenceto "dying ones" suggeststhat the piece may have been
writtenin the earlyyearsof the Civil War.
' Mary Putnam Jacobi, ed., Women's Medical Association of New York City, 504;
Jacobi,Value of Life, 229, 237.

. . . thelaws of healthand thoseof religiongo handin hand;thetwofunda-
mentallyagree.. Temperance,honesty, obedienceto parents,truthfulness,
chastity, recognitionof sacredties,and brotherly kindnessare no less in ac-
cordancewith the laws of bodilyand mentalhealth,thantheyare withthe
laws and ordinances of theChristianreligion,and whenmansinsagainstone he
does also againsttheother.
In the introduction to one of his popularmedicalworks,Mitchellobserved
thathe was temptedto call his essays"lay sermons,so seriousdid some of
theirsubjectsseem to me." He comparedthe role of the physicianwho
treatednervouspatientsto that of the priesthearingconfession.In later
yearshe also maintained: "So great is my reverencefor supremewhole-
someness,that I should almostbe temptedto assertthatperfecthealthis
virtue."54
Mental hygienistsin the Gilded Age for the most part disavowed the
more repressiveaspectsof theirchildhoods.They did not speak of break-
ing the will, but of trainingit in the properdirection.While complaining
of a breakdownin discipline,theybelievedthat"undue repressiondwarfs
the facultieswhen it does not derangethem."55The abstemiousness, the
joyless Sundays,the constantexhortationsto searchone's conscience-all
seemed more likelyto promoteillness than genuine piety.
In place of such a regimen,mental hygienistshoped to substitute
"rationalenjoyment"that mightbring "warmthand sweetness"into the
lives of the sturdyNew Englanderswho had inheriteda "coldness and
austerity of manner"fromtheirancestors.Mitchellnoted his fearof men
who had no "pettyvices," and one physicianwentso faras to declarethat
"even syphilismustbe acknowledgedto be a rarercause of insanitythanthe
enforcedcelibacywhich our civilizationdemands or the excesses which
marriage sometimesallows." If this proved an unfortunateprediction
about the relationshipbetweensyphilisand mentalillness,the liberalizing
intentionis still clear.56
But the innatecautionof physiciansof thisgeneration,theirfearof loss
of controland of inordinatewants thatcould not be satisfied,prevented
them fromventuringtoo far in the directionof freedom.They endorsed
"Stearns, Insanity,216; S. Weir Mitchell,Doctor and Patient (Philadelphia, 1904), 6;
S. Weir Mitchell, Address on Opening of the Instituteof Hygiene of the Universityof
Pennsylvania(Philadelphia, 1892), 4.
M Tuke, Insanityin Ancientand Modern Life, 196. By the late-nineteenth century,min-
isterstoo favoredless restrictive
child-rearing
methods.
'6Page, "How Can We Escape Insanity?" 198; BeverleyR. Tucker, S. Weir Mitchell:
A Brief Sketchof His Life with Personal Recollections(Boston, 1914), 48; Folsom, "The
Preventionof Insanity,"89; Wardner,"Thoughtson Insanityand Its PreventableCauses,"
385-86.

theclosesupervision of children-thecarefulguardingfromthecradle-
againstsignsof morbidintrospection, fantasy,or willfulness,justas par-
entsof a preceding generation mighthavewatchedforevidencesof sin.
They recommended outdoorexerciseor naturestudynot for children's
enjoyment but for health.Physicians of thisgeneration also preferred
gymnasticsto morestrenuous intercollegiate
sports;evenrollerskating, if
indulgedin at greatspeed,mightprovetoo exhilarating.57
Mentalhygienists offeredan outletforindividuals whofoundthepres-
suresof a demanding societyexcessive-licenseto seek restand repair
undertheguidanceof a sympathetic physician.
Ironically,
prudence rarely
characterizedthelivesof thementalhygienists. Good Victorians, someof
the mostardentadvocatesof mentalhealthwerefiercely ambitious and
prodigiousworkers. Mitchellmadeas manyas fifty-two housecalls in a
singleday,foundtimeforresearch andclinicduties,and had a consulting
practicethatbrought$70,000 in a good year.He even beganwriting
novelsto staveoffboredomin hisleisurehours.Indeed,Mitchellregularly
departedforvacations in a stateof exhaustion;and it was whilerecover-
ingfromone suchepisodethathe wroteWearand Tear,a bookthatelo-
quentlywarnedothersof thedangersof overwork.58
Mentalhygienists wereperhapsno moreinconsistent thanothermoral
counselorswho urgedfollowersto heed theiradviceratherthantheir
actions.For thosewho had experienced the social and personalstrains
aboutwhichtheywrote,prescriptions forhealthmayvariously have re-
flectedsatisfactory
personalsolutionsto theirown problems, attemptsto
remedytheperceivederrorsof theirown upbringing, and perhapseven
goals forothersthattheythemselves couldnot,perhapsdid notwishto,
achieve.Perhapssomeconsidered themselvesspecialindividuals, triedand
testedforhigherends.59
Whateverthe personaldimensionof theirwork,mentalhygienists
addressedthemselves to the culturaldiscontinuitiesthattroubledmany
Americansin the late-nineteenth century.Life-styles and values had
changeddrasticallysincethe1850sand fornonemorethanforphysicians
5?Nathan Allen,"PhysicalCulture,"CollegeArchives(AmherstCollege); Gray,"In-
sanity,"54-55;Folsom,"The Prevention of Insanity,"
90.
8
LikeGeorgeM. Beardand MaryPutnamJacobi,Mitchellalso suffered fromreligious
ill healthin adolescence,
terrors, and had at leasttwo severeboutsof nervousness
as an
adult.His brother died of tuberculosis
in Weir Mitchell'syouth.See AnnaRobesonBurr,
Weir Mitchell: His Life and Letters(New York, 1929); ErnestEarnest,S. Weir Mitchell:
Novelistand Physician
(Philadelphia,
1950); MargaretC.-L.Gildea andEdwinF. Gildea,
"Personalities
of American
Psychotherapists:
Mitchell,Salmon,Riggs,"Americanjournal
of Psychiatry,101 (Jan. 1945), 464-66.
" MaryPutnamJacobisuggested thatsuperior
individuals,
includingscholars,
poets,and
statesmen
werereadyto sacrifice
theirhealthforhighergoals.Jacobi,ValueofLife,201.

like Beard who made the difficult transitionfromvillage Congregational-
ism to scienceand New York City.A generationof Americanssoughtnew
certaintyas old truthsfailed them. Some turnedaway fromreligionen-
tirely.Otherslooked to new faithslike ChristianScience,whichclaimedto
be both science and religion,and New Thought; both took root in the
late 1870s and 1880s.60 Bolstered by the growing prestigeof science,
mental hygienistscontributedto this quest by providinga secular rather
than a religiouscontextfor evaluatingthe good life.
Physicianswere just beginningto offersuch advice in the Gilded Age,
but by 1917 theywere widelyacceptedas expertson mattersof personal
happiness and social welfare,once fields largely outside their domain.
Definitionsof healthalso changed.In Beard's day,humancapacityseemed
almosttragicallylimited.But thegenerationthatadmiredTheodoreRoose-
velt preferredWilliam James'exhortation thatthewill could open "deeper
and deeper levels of energy"to admonitionsof prudence.When James
wrotehis famousessay,"The Energiesof Men," in 1907, he actuallyre-
verseda positionhe had takenfifteenyearsearlier.Then he had argued:
"We mustchange ourselvesfroma race that admiresjerk and snap for
theirown sakes,and looks down upon low voices and quiet ways as dull,
has calm forits ideal, and fortheirown sakes
to one that,on the contrary,
loves harmony,dignity,and ease." In the interveningyears,both James
and Americanculturehad changed.61
" Donald Meyer, The Positive Thinkers: A Study of the American Quest for Health,
Wealth and Personal Power from Mary Baker Eddy to Norman Vincent Peale (Garden
City, N.Y., 1965).
"William James,The Energies of Men (New York, 1914); William James,Talks for
Teachers on Psychologyand to Studentson Some of Life's Ideals (New York, 1962), 99-
112. On mental health in the Progressiveera, see Sicherman,"The Quest for Mental
Health," 391-410.


The Paradox of Prudence Mental Health in The Gilded Age

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The Paradox of Prudence: Mental Health in the Gilded Age

Author(s): Barbara Sicherman

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iHYSICIANS in the late-nineteenthcenturytook the lead in tellingthe

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Althoughprimarily concerned withintellectual precocity,mentalhy-

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