‘What a weak barrier is truth when it stands in the way of any hypothesis’, observed Mary Wollstonecraft in the 1790s, irritated by Rousseau’s claim that women were coquettes by nature. Her remark could stand as epigraph to Lisa Appignanesi’s Mad, Bad and Sad: A History of Women and the Mind Doctors from 1800 to the Present. Take the case of Martha Hurwitz, who fell into the hands of Henry Cotton, superintendent of the Trenton State Hospital in New Jersey in the early twentieth century. Cotton advocated radical surgery to eliminate the ‘chronic pus infections’ that he claimed were the source of psychotic illness. An intelligent but impoverished woman, Martha was admitted to the hospital for being ‘talkative and restless’, possibly a reaction against a bad marriage and parents with conventional ideas about female behaviour. Diagnosed as suffering from ‘Septic Psychosis Schizophrenia’, she was subjected to typhoid vaccine, tonsillectomy and tooth extraction. This was merely the beginning of fifty-four years of invasive treatments, including repeated surgery, induced insulin comas, electric shocks and massive overdoses of drugs.
What is mental illness? How can it be categorised and accurately diagnosed? What are appropriate treatments for the mentally disturbed, and what role can science play? What is the interplay between body and mind in making us sane or crazy? And what is the best way to regulate the proliferating